Franklin Jason H, Wright Erin D
Department of Otolaryngology, University of Western Ontario, London, Ontario, Canada.
Am J Rhinol. 2007 Mar-Apr;21(2):214-7. doi: 10.2500/ajr.2007.21.3011.
The aim of this study was to establish the effect of absorbable dressing on postoperative discomfort and mucosal healing after sinus surgery. A prospective, randomized, controlled, blinded study was performed.
Patients 18-80 years old undergoing sinus surgery were enrolled in the study. Each patient's ethmoid cavities were randomized to receive either absorbable dressing or the standard nonabsorbable sinus packs. Therefore, patients served as their own control. Preoperative as a CT scan and intraoperative endoscopic photographs were used for staging within the Lund-Mackay system. The procedure was performed as the indicated by extent of disease. The remaining absorbable dressing was removed at 2 weeks by endoscopic suctioning in the clinic. Patients completed questionnaires regarding sinus symptoms and discomfort. Postoperative endoscopic appearance was graded by a single rhinologist. Length of follow-up was 6 months.
Thirty-five patients were randomized. There were no significant adverse events in either group. Patients' symptom scores improved at 2 weeks and at 1 and 3 months when compared with preoperation. Both groups had similar preoperative grade of disease and extent of surgery. Endoscopic appearance of the absorbable cavity showed a trend toward improvement at 2 weeks (p < 0.05). Endoscopic appearance showed a similar trend toward improvement at 1, 3, and 6 months in the absorbable group (NS). Twenty-seven patients had a strong preference for a particular nasal packing of which 16 of 27 (59.3%) patients preferred the absorbable dressing.
The absorbable dressing showed a trend toward positive effect on early wound healing and in late results. Strong patient preference was indicated for the absorbable dressing over standard sponges.
本研究的目的是确定可吸收敷料对鼻窦手术后不适和黏膜愈合的影响。进行了一项前瞻性、随机、对照、双盲研究。
纳入18至80岁接受鼻窦手术的患者。将每位患者的筛窦随机分为接受可吸收敷料或标准不可吸收鼻窦填塞物。因此，患者自身作为对照。术前进行CT扫描，术中使用内镜照片在Lund-Mackay系统内进行分期。手术按疾病范围进行。术后2周在门诊通过内镜吸引清除剩余的可吸收敷料。患者完成关于鼻窦症状和不适的问卷。术后内镜表现由一名鼻科医生进行分级。随访时间为6个月。
35例患者被随机分组。两组均无显著不良事件。与术前相比，患者的症状评分在术后2周、1个月和3个月时有所改善。两组术前疾病分级和手术范围相似。可吸收组筛窦的内镜表现在术后2周有改善趋势（p<0.05）。可吸收组在术后1个月、3个月和6个月时内镜表现有类似的改善趋势（无统计学意义）。27例患者对特定的鼻腔填塞物有强烈偏好，其中27例中的16例（59.3%）患者更喜欢可吸收敷料。
可吸收敷料对早期伤口愈合和后期结果显示出积极影响的趋势。与标准海绵相比，患者对可吸收敷料有强烈偏好。
