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

内镜鼻窦手术后伤口愈合中类固醇与抗生素浸渍可吸收鼻腔填塞物的比较:一项随机、双盲、安慰剂对照研究

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Abstract

INTRODUCTION: 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 4cm biodegradable material were applied in each ethmoid cavity. One of them was impregnated with saline solution, while the second one with steroid, or with antibiotic. 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.

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