The effect of platelet-rich fibrin (PRF) on wound healing, adhesion, and hemostasis after endoscopic sinus surgery in patients with nasal polyposis
American journal of otolaryngology. 2021;42(5):103010
PURPOSE Chronic rhinosinusitis (CRS) is one of the most common chronic diseases seen worldwide. Endoscopic sinus surgery (ESS) has become a widely accepted procedure for medically refractory chronic rhinosinusitis and nasal polyps. Prevention of revision surgery often depends on good wound healing and less adhesion formation. In recent years, the effects of platelet-rich fibrin (PRF) on tissue healing have been addressed in many surgical branches, especially for dental implant surgery and plastic surgery. METHODS This prospective study was conducted with 50 patients who underwent endoscopic sinus surgery for the diagnosis of nasal polyposis. While the middle meatus in one nasal cavity was filled with PRF and supported with Nasopore, only Nasopore was used in the other nasal cavity middle meatus. The patients were followed up clinically at weeks 1, 2, 3, 4, 8, and 12 postoperatively. The assessor determined the presence of adhesion, crusting, bleeding, frontal ostium stenosis, granulation, and infection, and if present, the grades of these complications were scored according to a questionnaire. RESULTS In our study, adhesion, infection, bleeding, granulation, and frontal ostium stenosis were less common in the PRF group, and a statistically significant difference was found between the groups. CONCLUSION In our study, better results were obtained in terms of adhesion, infection, bleeding, granulation, and frontal ostium stenosis after ESS as a result of the effects of PRF on wound healing. The application of PRF is an inexpensive and easy procedure. PRF can be a good alternative to other types of tampons after ESS.
The Hemostatic Efficacy of Hydrogen Peroxide Irrigation to Control Intraoperative Bleeding in Adenoidectomy
Turkish archives of otorhinolaryngology. 2018;56(4):193-198
Objective: Although adenoidectomy is generally accepted as a safe procedure, intraoperative hemorrhage is still the most common and potentially life-threating complication, especially in pediatric patients. We evaluated the clinical effect of intraoperative hydrogen peroxide irrigation with respect to hemostasis and operation times in pediatric adenoidectomy. Methods: This was a prospective, randomized, double-blind study to investigate hydrogen peroxide solution in hemostasis in pediatric patients undergoing adenoidectomy. The patient, the surgeon, and the study nurse were blinded to the surgical technique used. Results: One hundred seventeen (56 males and 61 females) consecutive pediatric patients with a mean age of 5.46+/-1.19 years were included in the study. There were 58 patients in the hydrogen peroxide group (median age: 6 years, mean age: 5.62+/-1.28 years) and 59 patients in the control group (median age: 5 years, mean age: 5.31+/-1.07 years). No significant difference was observed between the two groups with respect to age (p=0.151), gender (p=0.646), or adenoid size (p=0.767). On the other hand, the difference between the groups with respect to operation and hemostasis times was found to be statistically significant (p<0.001 for both). The average operation times were 8.67+/-0.48 min in the hydrogen peroxide group and 12.30+/-0.69 min in the control group. The average hemostasis times were 3.67+/-0.27 min in the hydrogen peroxide group and 5.73+/-0.31 min in the control group. Conclusion: Hydrogen peroxide solution can be effectively used in adenoidectomy for reducing intraoperative blood loss and for economic benefits.