Use of Fibrin Glue as a Hemostatic in Endoscopic Sinus Surgery

Autor: Ephraim Eviatar, Nathan Shlamkovich, Michael Vaiman, Samuel Segal
Rok vydání: 2005
Předmět:
Adult
Male
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Turbinectomy
Blood Loss
Surgical
Fibrin Tissue Adhesive
Postoperative Hemorrhage
Hemostatics
law.invention
03 medical and health sciences
Sleep Apnea Syndromes
0302 clinical medicine
Double-Blind Method
Randomized controlled trial
law
Outcome Assessment
Health Care
otorhinolaryngologic diseases
medicine
Humans
Tampons
Surgical
Prospective Studies
Sinusitis
030223 otorhinolaryngology
Fibrin glue
Prospective cohort study
Pain
Postoperative
rhinorrhea
medicine.diagnostic_test
business.industry
Endoscopy
General Medicine
Middle Aged
Surgery
Nasal Mucosa
Paranasal sinuses
medicine.anatomical_structure
Otorhinolaryngology
Tears
030220 oncology & carcinogenesis
Anesthesia
Submucous Resection
Female
medicine.symptom
business
Zdroj: Annals of Otology, Rhinology & Laryngology. 114:237-241
ISSN: 1943-572X
0003-4894
Popis: Endoscopic sinus surgery (ESS), especially when combined with turbinectomy and/or with submucous resection of the septum, may involve postoperative bleeding that might end with nasal packing. Nasal packing causes pain, rhinorrhea, and inconvenience and may not stop the postoperative bleeding. The aim of our study was to compare the hemostatic properties of the second-generation surgical sealant Quixil (Crosseal) with those of nasal packing in ESS. We performed a prospective randomized trial in 64 consecutive patients who underwent ESS and presented excessive intraoperative and/or postoperative bleeding. They were allocated by the sealed-envelope method into two groups. A routine ESS procedure was ended with Merocel nasal packing in group 1, and with aerosol application of Quixil sealant at the operative site in group 2. The hemostatic effects were evaluated objectively in the clinic by anterior rhinoscopy and endoscopy and assessed subjectively by the patients at follow-up visits. In group 1, various types of postoperative bleeding occurred in 25% of patients. In group 2 there was no postoperative bleeding, except for 1 case of late hemorrhage (3.12%). Drainage and ventilation of the paranasal sinuses were not impaired. There were no allergic reactions to the glue. We conclude that aerosol application of fibrin glue can be readily performed in ESS, requires no special treatment (antibiotics), and appears to have an adequate hemostatic effect. The use of this second-generation glue in ESS appears to stop nasal bleeding well and to be relatively safe and convenient.
Databáze: OpenAIRE
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