The effects of Vaseline gauze strip, Merocel, and Nasopore on the formation of synechiae and excessive granulation tissue in the middle meatus and the incidence of major postoperative bleeding after endoscopic sinus surgery☆

Abstract

Among patients who had undergone ESS for rhinosinusitis with or without polyps, the incidence of synechiae and excessive granulation tissue in the middle meatus and major postoperative bleeding in the patients who received Vaseline gauze packing was equivalent to the incidence of these complications in the patients who received Merocel. Nasopore was not superior to the other two nonabsorbable packing materials.

Merocel versus Nasopore for Nasal Packing: A Meta-Analysis of Randomized Controlled Trials

“…Given this, ongoing attempts have been carried out to develop absorbable biomaterials that can control bleeding effectively, provide middle turbinate support, and promote wound healing yet not require removal. Nasopore, one of the most prevalent absorbable agents has advantages including biodegradability, ease of manipulation, and no need for post-operative removal; however it has been reported that Nasopore tended to induce excessive granulation tissue formation during the early stages of wound healing postoperatively [9], results that conflicted with those of previous trials. Therefore, this meta-analysis was conducted and the pooled results of each outcome were concisely described from primary to secondary outcome measures.…”

“…Two trials have reported that Nasopore packing caused significantly less pain and bleeding during removal than did Merocel packing [6], [7]; another study showed little difference in nasal symptoms between the two packing materials 5 days after surgery [8], and still another reported that Nasopore was a significant factor in the formation of excessive granulation tissue 3–4 weeks after FESS [9]. To address this issue, we performed a meta-analysis that included all available data from randomized controlled trials (RCTs) that compared Merocel with Nasopore as a packing material at the end of nasal surgery with regard to the subjective severity of the symptoms.…”

Association of rhinostomy shape and surgical outcome after endoscopic endonasal dacryocystorhinostomy

“…Nasopore is a bioresorbable dressing for the nasal cavity, and is composed of fully synthetic, biodegradable foam that absorbs fluids while supporting and providing pressure to the surrounding tissue. As such, Nasopore can prevent the formation of postoperative adhesions [24,25]. It can also accelerate wound healing by providing a wet dressing environment.…”

“…Merocel is a polymer of hydroxylated polyvinyl acetate, a material containing cavities capable of absorbing fluid. However, it is known to cause pain and frequent bleeding upon removal, with an increased risk of adhesion formation [16,17,25]. The removal of Merocel and potential bleeding after EDCR may influence rhinostomy shape.…”

Comparison Study of the Use of Absorbable and Nonabsorbable Materials as Internal Splints after Closed Reduction for Nasal Bone Fracture

“…Because the functions of the internal splint include the stabilization of the bone segments, epistaxis control, prevention of synechia formation, and discharge absorption [1], the splint material is important. Furthermore, nasal packing in the internal splint can cause painful side effects, including dyspnea, sore throat, and headache, and many studies concerning the packing materials have been reviewed in the literature [1,3,4,5,6,7,8,9]. …”