Steroid vs. antibiotic impregnated absorbable nasal packing for wound healing after endoscopic sinus surgery: a randomized, double blind, placebo-controlled study

Blazej Grzeskowiak, Malgorzata Wierzchowska, Rafal Walorek, Malgorzata Seredyka-Burduk, Katarzyna Wawrzyniak, Pawel Krzysztof Burduk
2018 Brazilian Journal of Otorhinolaryngology  
Endoscopic sinus surgery can lead to crusting or synechiae formation, which can affect the healing process. Objective: The aim of our study was to compare the influence of steroid versus antibiotic versus saline solution impregnated absorbable nasal spacers on postoperative wound healing and patient satisfaction. Methods: Eighty patients, 33 women and 47 men, were enrolled in this study. At the end of the surgery, two pieces of 4 cm biodegradable material were applied in each ethmoid cavity.
more » ... ethmoid cavity. One of them was impregnated with saline solution, while the second one with steroid, or with antibiotic. ଝ Please cite this article as: Grzeskowiak B, Wierzchowska M, Walorek R, Seredyka-Burduk M, Wawrzyniak K, Burduk PK. Steroid vs. antibiotic impregnated absorbable nasal packing for wound healing after endoscopic sinus surgery: a randomized, double blind, placebo-controlled study. Braz J Otorhinolaryngol. 2019;85:473---80. 474 Grzeskowiak B et al. Results: We observed statistically significant differences in the Lund---Kennedy score between the control and both treatment groups: for the Antibiotic-group on days 10 and 30 (p = 0.009; p = 0.009) and for the Steroid-group on day 90 (p = 0.008). The extended endoscopic appearance of nasal mucosa indicated statistically significant differences in crust formation on day 10 comparing the steroid and control dressing (p = 0.025), in secretion type on days 10 and 30 comparing the antibiotic and control dressing (p = 0.003; p = 0.016) and additionally for steroid and control on day 90 (p = 0.046). On Day 90 we observed statistically significant differences in the absence of mucosal edema in the S-group compared to controls (p = 0.007). Conclusions: The results of this study reveal the significant positive influence of steroid-and antibiotic-impregnated biodegradable nasal packing on the postoperative healing process and patient satisfaction compared to the saline soaked dressing. © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/). = 0,003; p = 0,016) e adicionalmente para esteroide e controle no dia 90 (p = 0,046). No dia 90, observamos diferenças estatisticamente significantes na ausência de edema da mucosa no grupo E (esteroide) em relação aos controles (p = 0,007). Conclusões: Os resultados deste estudo revelam uma influência positiva significante no uso de tampão nasal biodegradável embebido em esteroides e antibióticos no processo de cicatrização pós-operatória e satisfação do paciente em comparação com o curativo embebido em solução salina.
doi:10.1016/j.bjorl.2018.04.002 pmid:29807811 fatcat:2pgslq5s3beudbt4rhqmsmhjmy