水凝胶银抗菌敷料（AQUACEL® Ag Advantage）能减轻鼻内镜鼻窦术后的填塞取出所带来的痛苦。

AQUACEL® Ag Advantage reduces the stress of postoperative packing removal after endoscopic sinus surgery.

机构信息

Musashi Kosugi Hospital, Nippon Medical School, Department of Otolaryngology, Nakahara-Ku, Kawasaki, Japan; Tama Nagayama Hospital, Nippon Medical School, Department of Otolaryngology, Tama, Tokyo, Japan.

Japan Community Health Care Organization Osaka Hospital, Department of Otorhinolaryngology, Fukushima, Osaka, Japan; Osaka University, Department of Otorhinolaryngology-Head and Neck Surgery, Suita, Japan.

出版信息

Braz J Otorhinolaryngol. 2023 Sep-Oct;89(5):101292. doi: 10.1016/j.bjorl.2023.101292. Epub 2023 Jul 18.

DOI:10.1016/j.bjorl.2023.101292

PMID:37579570

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10448402/

Abstract

OBJECTIVE

After Endoscopic Sinus Surgery (ESS), packing plays an important role in wound healing and hemostasis. However, the effect of the packing removal procedure on physician stress has not been evaluated. The purpose of this study was to evaluate physician stress during packing removal for patients treated with AQUACEL® Ag Advantage versus KALTOSTAT®.

METHODS

This retrospective study included 15 patients who underwent packing with ESS for chronic rhinosinusitis performed at two centers; 9 were treated with AQUACEL® Ag Advantage and 6 were treated with KALTOSTAT®. Physician stress during packing removal was evaluated with the National Aeronautics and Space Administration-Task Load Index (NASA-TLX). The time required to remove the packing and the number of instruments used in the procedure were recorded. Postoperative bleeding (Boezaart bleeding score) and wound healing were graded. Patient symptoms on the day after surgery and pain during packing removal were assessed using a visual analog scale.

RESULTS

Computed tomography scores, asthma complications, and blood eosinophil counts were significantly higher in the AQUACEL® Ag Advantage group. Patient symptoms on the day after surgery were not significantly different between the two groups. Physician stress during the task of packing removal was significantly lower in the AQUACEL® Ag Advantage group than in the KALTOSTAT® group (35.5 vs. 81.0, p=0.016) according to the NASA-TLX scores. The number of instruments used in the procedure was significantly lower in the AQUACEL® Ag Advantage group than in the KALTOSTAT® group (3.0 vs. 6.0, p=0.015). There were no significant differences in procedure time for packing removal, postoperative bleeding, wound healing, or patient pain at the time of packing removal between the groups.

CONCLUSION

Physicians feel stressed about packing removal. In addition, AQUACEL® Ag Advantage is useful for packing after ESS, requiring fewer instruments for the procedure than KALTOSTAT® and reducing physician stress about the procedure.

LEVEL OF EVIDENCE

Level 3.

摘要

目的

内镜鼻窦手术后（ESS），填塞在伤口愈合和止血中起着重要作用。然而，填塞去除过程对医生压力的影响尚未得到评估。本研究的目的是评估使用 AQUACEL®Ag Advantage 与 KALTOSTAT®治疗的患者在 ESS 中进行填塞去除时医生的压力。

方法

这项回顾性研究纳入了在两个中心接受 ESS 治疗慢性鼻鼻窦炎并进行填塞的 15 名患者；其中 9 名使用 AQUACEL®Ag Advantage 治疗，6 名使用 KALTOSTAT®治疗。使用美国国家航空航天局任务负荷指数（NASA-TLX）评估填塞去除过程中医生的压力。记录去除填塞所需的时间和使用的器械数量。记录术后出血（Boezaart 出血评分）和伤口愈合情况。使用视觉模拟评分法评估术后第一天患者的症状和填塞去除时的疼痛。

结果

AQUACEL®Ag Advantage 组的计算机断层扫描评分、哮喘并发症和血嗜酸性粒细胞计数显著升高。两组患者术后第一天的症状无显著差异。根据 NASA-TLX 评分，AQUACEL®Ag Advantage 组在填塞去除任务中的医生压力显著低于 KALTOSTAT®组（35.5 比 81.0，p=0.016）。AQUACEL®Ag Advantage 组在该程序中使用的器械数量明显少于 KALTOSTAT®组（3.0 比 6.0，p=0.015）。两组患者在填塞去除时间、术后出血、伤口愈合或填塞去除时的患者疼痛方面无显著差异。