The effects of the time of intranasal splinting on bacterial colonization, postoperative complications, and patient discomfort after septoplasty operations

Karataş, Abdullah; Pehlivanoğlu, Filiz; Şalvız, Mehti; Kuvat, Nuray; Cebi, Işıl Taylan; Dikmen, Burak

doi:10.1016/j.bjorl.2015.11.008

Cited by 16 publications

(15 citation statements)

References 20 publications

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“…The authors concluded that silicone splints might be retained intranasally up to 10 days without increasing infection-related early complication rates. 7 Ozdogan et al examined post-septoplasty complications in 109 patients who had not received prophylactic antibiotic therapy. The authors reported 1 case (0.9%) of local infection in a patient who had the splints removed on day 3 after septoplasty.…”

Section: Discussionmentioning

confidence: 99%

Intranasal Septal Splints: Prophylactic Antibiotics and Nasal Microbiology

Ritter

Alkan

Yahav

et al. 2019

Ann Otol Rhinol Laryngol

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Objectives: Intranasal septal splints are often used in nasal septal surgeries. Routine use of postoperative antibiotics is an accepted practice, although data regarding its efficacy in preventing postsurgical complications are limited. This study aimed to examine bacterial colonization on septal splints following prophylactic antibiotic therapy and the association with postoperative infections. Methods: Fifty-five patients underwent septoplasty by a single surgeon between March 2015 and April 2016. All had intranasal septal splints and were given antibiotic prophylaxis for 7 days until removal of splints. Nasal cultures were taken before surgery, and septal splints were examined for bacterial colonization following their removal. Results: Thirty-six patients (65%) had positive nasal culture prior to surgery. The most common isolates were Staphylococcus aureus (30%) and Enterobacteriaceae species (66%). All these patients had postoperative bacterial colonization on septal splints. In 15 patients with negative preoperative cultures, bacteria were isolated postoperatively. An increased resistance profile was documented postoperatively in 9 patients (16%), including two with multidrug resistance. In two of these patients preoperative wild-type strains acquired antibiotic resistance postoperatively. No adverse drug reactions to antibiotics were reported. Conclusions: Increased bacterial growth and emergence of resistant strains were observed on intranasal septal splints despite prophylactic antibiotic treatment. Nonetheless, this did not translate into clinical infection. Thus, considering antibiotics overuse and increasing bacterial resistance, further research is needed to determine the role of antibiotic prophylaxis in the setting of intranasal splints.

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Section: Discussionmentioning

confidence: 99%

Intranasal Septal Splints: Prophylactic Antibiotics and Nasal Microbiology

Ritter

Alkan

Yahav

et al. 2019

Ann Otol Rhinol Laryngol

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“…[8] Other methods of stabilizing the septum include splints [9] clips, [10] there are recommendations of various materials including cotton tape, gauze, paraffin gauze, Telfa, Merocel, sponges, and silicone nasal splints for this purpose. [11] In septoplasties, the mucoperichondrial and mucoperiosteal flap layer on both sides of the midline cartilaginous septum are elevated, and the deviated portion of the cartilage or bone is removed. Then, the flaps are placed back together in the midline.…”

Section: Discussionmentioning

confidence: 99%

Use of Nasal Septal Splint with Clip in Septoplasty: A Retrospective Study

Sahoo¹,

Sarma²

2020

bhjournal

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“…Medicated packs like Ribbon gauze, fingerstall packs, polyvinyl acetate sponge (Merocel), cellulose sponges, and carboxymethylcellulose, balloon tamponade has been described by Rowan V, et al [8]. Other methods of stabilizing the septum include, Splints [9] Clips [10], various materials including cotton tape, gauze, paraffin gauze, Tefla, Merocel, sponges, and silicone nasal splints have been recommended for this purpose [11]. I septoplasties, the mucoperichondrial and mucoperiosteal flap layer on both sides of the midline cartilaginous septum is elevated, and the deviated portion of the cartilage or bone is removed.…”

Section: Discussionmentioning

confidence: 99%

Septoplasty without Packing, Splints or Clip - Our Experience

Varghese¹

2017

IJSST

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Introduction: Septoplasty is a very commonly done surgery for deviated nasal septum in any Otorhinolaryngological department. Sometimes it may be combined with other procedures like FESS, synechiae release, AC polypectomy, Adenoidectomy, or turbinoplasty also. As the last step, nasal cavity is often packed with medicated gauze or splinted or rarely clips are also used for stabilization and to promote adhesion between the mucosal flaps of the septum. Most often a nasal pack is the choice for the surgeon as it is a simple procedure compared to splints and clips which are costly and have to be kept in the nose for variable time. This causes problems like, a blocked nose till the pack is removed, dry mouth, watering of eyes, and severe pain during removal of the pack blocked ears, headache, difficulty in swallowing, hypoxia, etc. We have conducted a prospective study 0f 58 patients undergoing Septoplasty for nasal blockage and these patients did not undergo any packing, or splints or clips Study Design: longitudinal observationalMethods: 58 patients, who came to our department with a complaint of nasal obstruction during the period of one year from October 2015 to October, 2016. There were 46 male and 12 female patients. Youngest patient was 10 year old and the oldest was 55 years. We sutured the septal mucosa with 4 zero vicryl with a few quilting sutures and then continuous sutures for the approximation of the flaps and to prevent hematoma of the septum .On the day of operation and later also they were followed up for any bleeding or ,hematoma .All these patients were initially assessed with NOSE score to assess the degree of blockage, and then followed up, on the next day after a suction clearance with the same criterion to assess the comfort level, and after 1 week and finally after 1 month . During the follow up the nasal cavities were looked for any synechiae, hematoma or perforation of the septum or residual deviation. Results:In one patient, minor bleeding occurred within a few hours in the recovery room and the nose was packed. In another patient, since there was no perfect hemostasis, packing was done on the table itself. For two patients, since there was a little bleeding, I .V Tranexamic acid 500 mg was given and no packing was done. No complication occurred for the rest of the patients. No patient had any long term complication. Conclusion:Septoplasty by putting multiple continuous trans septal sutures after an initial one or two quilting sutures for stabilizing the corrected septum with absorbable 4 zero polyglactin suturing material, without packs, clips or splints inside the nose is a very effective method of preventing hematoma, or synechiae inside the nose at the same time, avoiding all the problems with a foreign material inside the nose even though temporarily with an obstructed airway.Thus, Septoplasty can be a day care procedure. The only problem is the extra time required for putting the suture which is negligible when considering the advantages.

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The effects of the time of intranasal splinting on bacterial colonization, postoperative complications, and patient discomfort after septoplasty operations

Cited by 16 publications

References 20 publications

Intranasal Septal Splints: Prophylactic Antibiotics and Nasal Microbiology

Intranasal Septal Splints: Prophylactic Antibiotics and Nasal Microbiology

Use of Nasal Septal Splint with Clip in Septoplasty: A Retrospective Study

Septoplasty without Packing, Splints or Clip - Our Experience

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