Verim Ayşegül, Seneldir Lütfü, Naiboğlu Bariş, Karaca Çiğdem Tepe, Külekçi Semra, Toros Sema Zer, Oysu Çağatay
Department of Otorhinolaryngology/Head and Neck Surgery, Haydarpaşa Numune Educational and Research Hospital, Istanbul, Turkey.
Laryngoscope. 2014 Jul;124(7):1529-35. doi: 10.1002/lary.24543. Epub 2014 Jan 15.
OBJECTIVES/HYPOTHESIS: To analyze the differences between biodegradable and nondegradable nasal dressings with regard to their effects on wound healing in the short and medium term and on surgical outcomes in the long term, after endoscopic sinus surgery (ESS).
A prospective, randomized, partly blinded, controlled trial.
A total of 56 patients undergoing bilateral ESS for chronic rhinosinusitis with polyposis were enrolled and randomized to receive biodegradable (Nasopore; Stryker, Hamilton, ON, Canada) on one side and nondegradable packing (Merocel; Medtronic Xomed, Minneapolis, MN) on the opposite side. Postoperative morbidities (pain, bleeding, facial edema, nasal blockage) related to dressings were assessed on postoperative day 6. Wound healing (edema, crusting, secretions, synechia, granulation tissue formation, and percentage re-epithelialization) were evaluated at 2 weeks, 1 month, 3 months, and 6 months using modified Lund-Kennedy scores. Long-term assessment at 12 months was done using validated Lund-Kennedy scores.
Morbidities related to nondegradable packing were significantly higher than with degradable packing (Wilcoxon signed rank test, P<.01). Pain, bleeding, nasal blockage, and facial edema were significantly less with absorbable packing. No statistically significant difference was found between sinonasal cavities packed with biodegradable or nondegradable materials with regard to healing scores and percentage of re-epithelialization at 2 weeks, 1 month, 3 months, 6 months, and surgical outcomes at 1 year (P>.05). However, healing at 6 months was correlated with the preoperative Lund-Mackay radiology and surgery scores (Spearman's rho correlation test, P<.05 and P<.01, respectively).
No significant healing or surgical outcome differences were found between biodegradable and nondegradable packing. However pain, bleeding, nasal blockage, and facial edema were lower with biodegradable packing.
1b.
目的/假设：分析可生物降解和不可生物降解鼻腔敷料在内镜鼻窦手术（ESS）后对短期和中期伤口愈合以及长期手术结果的影响差异。
一项前瞻性、随机、部分盲法、对照试验。
共有56例因慢性鼻窦炎伴息肉接受双侧ESS的患者入组并随机分组，一侧使用可生物降解敷料（Nasopore；史赛克公司，加拿大安大略省汉密尔顿市），另一侧使用不可生物降解填充物（Merocel；美敦力Xomed公司，美国明尼苏达州明尼阿波利斯市）。术后第6天评估与敷料相关的术后发病率（疼痛、出血、面部水肿、鼻塞）。在术后2周、1个月、3个月和6个月使用改良的Lund-Kennedy评分评估伤口愈合情况（水肿、结痂、分泌物、粘连、肉芽组织形成和再上皮化百分比）。12个月时使用经过验证的Lund-Kennedy评分进行长期评估。
与不可生物降解填充物相关的发病率显著高于可生物降解敷料（Wilcoxon符号秩检验，P<.01）。可吸收敷料的疼痛、出血、鼻塞和面部水肿明显较少。在2周、1个月、3个月、6个月时，填充可生物降解或不可生物降解材料的鼻窦腔在愈合评分和再上皮化百分比以及1年时的手术结果方面未发现统计学显著差异（P>.05）。然而，6个月时的愈合情况与术前Lund-Mackay影像学和手术评分相关（Spearman等级相关检验，分别为P<.05和P<.01）。
可生物降解和不可生物降解敷料在愈合或手术结果方面未发现显著差异。然而，可生物降解敷料的疼痛、出血、鼻塞和面部水肿较轻。
1b。
