Usefulness of nasal packing with silver-containing carboxy methylated cellulose in endonasal sinus surgery

Auris Nasus Larynx. 2014 Jun;41(3):264-8. doi: 10.1016/j.anl.2013.10.009. Epub 2013 Oct 30.

Abstract

Objective: Silver-containing carboxymethylcellulose fiber dressing (Aquacel®-Ag) has been used to treat burns and ulcers with a large amount of exudate. The aim of this investigation was to confirm whether Aquacel®-Ag has beneficial effects when it is used as nasal packing.

Methods: We included 44 patients who underwent bilateral endoscopic sinus surgery due to chronic rhino-sinusitis. Beschitin-F® or Aquacel®-Ag was packed postoperatively into the bilateral middle meatus. Patient's comfort was recorded using a VAS, as well as wound healing, postoperative bleeding and local infection. Postoperative-specific organisms were also evaluated from the removed packing materials located in the middle meatus when they were removed on the 4th day after surgery.

Results: The scores for nasal obstruction and pain were not statistically different in each group. Postoperative bacteriologic studies indicated marked differences. Coagulase-negative staphylococci were predominant and potential pathogens were recovered in a few cases in the Aquacel®-Ag group. In contrast, potential pathogens, including Streptococcus pneumonia, Haemophilus influenza, and Gram-negative rods, were predominant in the Beschitin-F® group.

Conclusion: The results indicate that Aquacel®-Ag might contribute to hemostasis, wound healing, and patient comfort after endonasal surgery, similar to Beschitin-F®. Additionally, it may have advantages concerning the prevention of postoperative infection.

Keywords: Aquacel(®)-Ag; Beschitin; Endoscopic sinus surgery; Nasal packing; Silver-containing carboxy methylated cellulose.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Bandages
  • Carboxymethylcellulose Sodium / therapeutic use*
  • Chronic Disease
  • Endoscopy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain, Postoperative / prevention & control
  • Paranasal Sinuses / surgery*
  • Postoperative Care / methods*
  • Postoperative Hemorrhage / prevention & control*
  • Rhinitis / surgery*
  • Silver Compounds / therapeutic use*
  • Single-Blind Method
  • Sinusitis / surgery*
  • Surgical Wound Infection / prevention & control*
  • Treatment Outcome
  • Wound Healing

Substances

  • Silver Compounds
  • Carboxymethylcellulose Sodium