Comparison of polyvinyl acetate sponge and medicated ribbon gauge nasal pack following nasal surgery

S Maharjan; AK Jha; RR Joshi; AS Rijal; KK Shrestha; A Dhungana

S Maharjan Department of Otorhinolaryngology, Head and Neck Surgery, Nepal Medical College Teaching Hospital, Attarkhel, Gokarneshwor-8, Kathmandu, Nepal
AK Jha Department of Otorhinolaryngology, Head and Neck Surgery, Nepal Medical College Teaching Hospital, Attarkhel, Gokarneshwor-8, Kathmandu, Nepal
RR Joshi Department of Otorhinolaryngology, Head and Neck Surgery, Nepal Medical College Teaching Hospital, Attarkhel, Gokarneshwor-8, Kathmandu, Nepal
AS Rijal Department of Otorhinolaryngology, Head and Neck Surgery, Nepal Medical College Teaching Hospital, Attarkhel, Gokarneshwor-8, Kathmandu, Nepal
KK Shrestha Department of Otorhinolaryngology, Head and Neck Surgery, Nepal Medical College Teaching Hospital, Attarkhel, Gokarneshwor-8, Kathmandu, Nepal
A Dhungana Department of Otorhinolaryngology, Head and Neck Surgery, Nepal Medical College Teaching Hospital, Attarkhel, Gokarneshwor-8, Kathmandu, Nepal

Abstract

Nasal occlusive dressings are routine after nasal surgeries to arrest hemorrhage, to prevent septalhematoma, and to prevent postoperative adhesions. However, patients describe nasal packing
and its removal as their worst experience. Various types of nasal packs are available. Medicatedribbon gauge is the traditional form of nasal pack which consists of an open-mesh cotton as a carrierwhereas “Polyvinyl Acetate’ sponge is a compressed dehydrated material, an improvised one whichincreases in size and compresses blood vessels when rehydrated with normal saline. As Polyvinylacetate sponge is smooth and spongy, it causes less pain and abrasion while in-situ and removal. Thiswas a prospective comparative study done in tertiary hospital of Nepal. Patients were subjected toeither polyvinyl acetate sponge or ribbon gauge nasal pack following nasal surgery. Comparisonswere made in terms of pain score, maintenance of hemostasis and wound healing. There were 154patients in the study with 104 males and 50 females. The pain score when nasal pack was in-situ wassimilar in both groups whereas it was lesser in the polyvinyl acetate group on its removal. However,bleeding and adhesion were found to be similar. Crust formation was less in polyvinyl acetate group.Six synaechia were noted in ribbon gauge group only. Pain was significantly less during removal ofpolyvinyl acetate pack.

Keywords : bleeding, nasal packing, nasalpain, polyvinyl acetate, ribbongauze