Influence of chitosan-based dressing on prevention of synechia and wound healing after endoscopic sinus surgery: A meta-analysis

Am J Rhinol Allergy. 2017 Nov 4;31(6):401-405. doi: 10.2500/ajra.2017.31.4469.

Abstract

Introduction: Endoscopic sinus surgery (ESS) has had many complications, e.g., synechia formation. This meta-analysis investigated the effect of a novel chitosan-based dressing on prevention of synechia and wound healing after ESS.

Methods: We systematically searched various medical literature data bases and included the randomized controlled trials (RCT) regarding the effect of novel chitosan-based dressing on ESS. The study outcomes included synechia, granulations, hemostasis, crusting scores, and infection.

Results: Six RCTs, which involved 337 patients, were included in the meta-analysis. Compared with control intervention after ESS, chitosan-based gel dressing substantially inhibited synechia (risk ratio [RR] 0.28 [95% confidence interval {CI}, 0.15-0.54]; p = 0.0001), improved granulations (RR 1.47 [95% CI, 1.07-2.03]; p = 0.02), and hemostasis (RR 1.47 [95% CI, 1.07-2.03]; p = 0.02) but demonstrated no effect on crusting scores (standard mean difference -0.41 [95% CI, -1.06 to 0.23]; p = 0.21) and infection (RR 0.88 [95% CI, 0.51-1.52]; p = 0.64).

Conclusion: Compared with control intervention, chitosan-based dressing was associated with significantly reduced synechia and with increased granulations and hemostasis but showed no influence on crusting and infection after ESS.

Publication types

  • Meta-Analysis

MeSH terms

  • Bandages*
  • Chitosan / pharmacology*
  • Chitosan / therapeutic use
  • Endoscopy*
  • Humans
  • Paranasal Sinuses / surgery*
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control*
  • Tissue Adhesions / pathology
  • Wound Healing / drug effects*

Substances

  • Chitosan