Early complications of packing after nasal surgery with three different materials.

ABSTRACT

OBJECTIVE: To investigate and compare the early complications of nasal packing with three different packing materials after surgical trimming of nasal turbinates. DESIGN: From a group of patients admitted to two Ear, Nose and Throat Departments for surgical trimming of inferior turbinates, those who consented were included in this study. Randomised patient packs were used and randomisation was carried out by a third party not directly involved in the study. Patients' nostrils were packed with calcium sodium alginate (Kaltostat), glove finger packs or trousered paraffin gauze. SETTING: Two District General Hospitals (DGH) in the United Kingdom (UK) during the period from February 1989 to June 1990. SUBJECTS: 92 patients between the age of 16 years and 60 years who consented out of a population who were admitted to two DGHs for surgical trimming of inferior turbinates. MAIN OUTCOME MEASURES: The state of the nostrils in each patient was assessed by the authors (authors 1 and 3 in Hospital 1 and author 2 in Hospital 2) at the time of discharge and at a postoperative outpatient visit at 3 weeks after discharge. RESULTS: 5% of nostrils packed with calcium sodium alginate (Kaltostat), 27% of nostrils packed with glove finger packs and 20% of nostrils packed with paraffin trouser packs were found to have clots on discharge from the hospital. At the post-discharge followup, when each complication was considered separately, there were more complications in the group who had their nostrils packed for 48 hours (14.2%) than in those who had packs in for 24 hours (7.3%). Significantly less complications were seen at 3 weeks with paraffin gauze packs (6.6%) than in the other two packing material (13.9%). CONCLUSIONS: Our findings suggest that, of the pack types studied 1) nostrils packed with calcium sodium alginate (Kaltostat) leave less clots in the nostrils 2) leaving packing in for 48 hours produces significantly more complications in the early post-operative period especially with calcium sodium alginate.