Effectiveness of Polyvinyl Acetate Sheeted with Carboxymethyl Cellulose as a Packing Material after Septoplasty

Sung-Dong Kim; Dongwon Kim; Deok-Soo Kim; Ji-a Kim; Dong-Joo Lee; Kyu-Sup Cho

doi:10.18787/jr.2018.25.2.86

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Kim, Kim, Kim, Kim, Lee, and Cho: Effectiveness of Polyvinyl Acetate Sheeted with Carboxymethyl Cellulose as a Packing Material after Septoplasty

ORIGINAL ARTICLE

J Rhinol 2018;25(2):86-90.

Published online: 19 January 2018

DOI: https://doi.org/10.18787/jr.2018.25.2.86

Effectiveness of Polyvinyl Acetate Sheeted with Carboxymethyl Cellulose as a Packing Material after Septoplasty

Sung-Dong Kim, MD, Dongwon Kim, MD, Deok-Soo Kim, MD, Ji-a Kim, MD, Dong-Joo Lee, MD, Kyu-Sup Cho, MD

Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea

교신저자：조규섭, 49241 부산광역시 서구 구덕로 179 부산대학교 의학전문대학원 부산대학교병원 이비인후과학교실 Tel: +82-51-240-7824, Fax: +82-51-246-8668, E-mail: choks@pusan.ac.kr

Received 12 February 2018 Revised 29 May 2018 Accepted 25 August 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Objectives:

Although polyvinyl acetate (Merocel^®) has been widely used as a packing material after septoplasty, removable nasal packing can increase patient discomfort, local pain, and pressure. Furthermore, the removal of nasal packing has been described as the most uncomfortable and distressing feature associated with septoplasty. The purpose of this study was to investigate the efficacy of polyvinyl acetate with carboxymethyl cellulose sheet (Rhinocel^®) nasal packing on patient subjective symptoms, degree of bleeding, hemostasis, and wound healing following septoplasty.

Subjects and Method:

Forty patients with nasal septum deviation requiring septoplasty were included. Following surgery, one nasal cavity was packed with Rhinocel^® and the other one with Merocel^®. Patient subjective symptoms while the packing was in situ, hemostatic properties, pain on removal, degree of bleeding on removal, duration of hemostasis after removal, postoperative wound healing, and the cost of the pack were evaluated.

Results:

Although the two types of packing materials were equally effective in controlling postoperative bleeding after septoplasty, Rhinocel^® was significantly more comfortable while in situ and less painful on removal than Merocel®, which was associated with significantly more bleeding on removal and so more time was needed to control hemorrhage. There was no significant difference in postoperative wound healing or pack cost.

Conclusion:

The use of Rhinocel^® after septoplasty has less discomfort, greater patient satisfaction, and less bleeding on removal with no adverse reactions compared to Merocel^® packing. Therefore, Rhinocel^® may be a useful packing material after septoplasty.

Keywords: Carboxymethylcellulose sodium, Biocompatible materials, Nose, Septoplasty, Postoperative care, Pain, Polyvinyl acetate.

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Table 1.

Analysis of postoperative outcomes between Merocel and Rhinocel packing

Parameter	Type	Mean±SD	p-value
불편감(POD 0)	Merocel	5.76±2.52	0.024
불편감(POD 0)	Rhinocel	5.33±2.79
코막힘(POD 0)	Merocel	7.21±2.21	0.038
코막힘(POD 0)	Rhinocel	6.45±2.64
불편감(POD 1)	Merocel	4.91±2.22	0.027
불편감(POD 1)	Rhinocel	4.42±2.43
코막힘(POD 1)	Merocel	6.21±2.99	0.353
코막힘(POD 1)	Rhinocel	5.91±2.88
패킹 동안 출혈	Merocel	1.45±0.61	0.002
패킹 동안 출혈	Rhinocel	1.09±0.52
패킹 제거 시 통증	Merocel	6.30±2.33	<0.001
패킹 제거 시 통증	Rhinocel	4.21±2.38
패킹 제거 후 출혈	Merocel	1.42±0.75	<0.001
패킹 제거 후 출혈	Rhinocel	0.73±0.45
패킹 제거 후 지혈시간	Merocel	1.21±0.92	0.001
패킹 제거 후 지혈시간	Rhinocel	0.73±0.76

Data are expressed ad the mean±SD. POD: postoperative day

Table 2.

Postoperative healing assessment between Merocel and Rhinocel packing

POD	Type	Mean±SD	p-value
7	Merocel	1.81±0.52	0.714
7	Rhinocel	1.70±0.56
14	Merocel	1.21±0.31	0.328
14	Rhinocel	1.02±0.24
28	Merocel	1.00±0.00	1.000
28	Rhinocel	1.00±0.07

Data are expressed as the mean±SD. POD: postoperative day

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