1.
Comparison of the effect of aerosolized fibrin sealant and biodegradable synthetic polyurethane foam on hemostasis and wound healing after endoscopic sinus surgery: a prospective randomized study
Jung MS, Choi CH, Yu MS
International Forum of Allergy & Rhinology. 2017;7((11):):1089-1094
Abstract
BACKGROUND Use of absorbable packing materials after functional endoscopic sinus surgery (FESS) is associated with increased patient comfort and a lack of need for packing removal. Different materials may induce different patterns of mucosal healing and hemostasis. This study investigated the effect of fibrin sealant (FS; Tisseel) or biodegradable synthetic polyurethane foam (Nasopore(R) ) packing on hemostasis and wound healing after FESS. METHODS This prospective randomized controlled trial included 35 consecutive patients who underwent bilateral FESS for chronic rhinosinusitis. The patients were randomized to receive FS through aerosol spraying on 1 side and Nasopore packing on the opposite side. They were followed at 1, 2, 4, 8, and 12 weeks after surgery. Endoscopically visible packing material, crusting, adhesion, bleeding, granulation tissue formation, frontal sinus patency, and adverse effects were assessed. Subjective symptoms related to nasal packing were evaluated by using questionnaires quantified with a visual analogue scale. RESULTS No significant differences were found between the FS-treated side and the Nasopore-packed side with respect to postoperative bleeding, adhesion, or frontal sinus patency. However, crusting and granulation were significantly lower in FS-treated nostrils (p < 0.01). The patients' satisfaction and willingness to reuse the material were not significantly different between FS and Nasopore. There were no allergic reactions to either material. CONCLUSION FS and Nasopore were equally successful in achieving hemostasis and patient satisfaction after FESS. However, our results suggest that differential mucosal healing patterns may be induced by alternative absorbable hemostatic materials. FS-treated sides showed more optimal healing patterns than Nasopore-packed sides.
2.
Effect of aerosolized fibrin sealant on hemostasis and wound healing after endoscopic sinus surgery: A prospective randomized study
Yu MS, Kang SH, Kim BH, Lim DJ
American Journal of Rhinology & Allergy. 2014;28((4):):335-40.
Abstract
BACKGROUND The purpose of this study was to investigate the effect of aerosolized fibrin sealant (FS) compared with that of polyvinyl acetal sponge packing on hemostasis and wound healing after functional endoscopic sinus surgery (FESS). METHODS We conducted a prospective randomized controlled trial of the use of aerosolized FS in 41 consecutive patients who underwent bilateral FESS between February 2011 and March 2012. The patients were randomized to receive FS applied via an aerosol spray in one nasal cavity and polyvinyl acetal sponge packing in the opposite cavity. The patients were followed up at 1, 2, 4, 8, and 12 weeks postoperatively. Crusting, adhesion, bleeding, granulation tissue formation, infection, and frontal sinus ostium stenosis after endoscopic surgery were assessed using a grading scale. Subjective symptoms related to nasal packing were evaluated using questionnaires quantified by visual analog scales. RESULTS The degree of granulation and crusting was significantly reduced in the side treated with FS compared with the polyvinyl acetal sponge side, as were bleeding and pain during nasal packing removal (p < 0.05). In addition, general satisfaction and willingness to reuse the material were significantly higher for the FS-treated side than for the polyvinyl acetal sponge-packed side (p < 0.001). CONCLUSIONS Compared with polyvinyl acetal sponge, aerosolized FS shows beneficial effects on hemostasis and wound healing after FESS. The application of FS resulted in a high degree of patient satisfaction without additional morbidity.