Scanning electron microscopy of hydroxylated polyvinyl acetal and conventional gauze strip nasal packing materials

The application of nasal packing is one of the most commonly performed procedures in rhinology. Various materials have been used as nasal packing, including conventional gauze strips and hydroxylated polyvinyl acetal. Complications related to nasal packing may cause problems that lead to increased morbidity. Among those complications, infectious ones range from localized infection in the nasal cavity to toxic shock syndrome. The purpose of this study was to evaluate conventional gauze strips and hydroxylated polyvinyl acetal nasal packing materials by scanning electron microscopy, to reveal their surface characteristics that would promote or prevent the development of infectious complications. The two types of materials were examined before and after application into the nasal cavity. Scanning electron microscopy demonstrated that hydroxylated polyvinyl acetal material had a smooth surface, whereas conventional gauze strips had an irregular surface with fibers projecting, thus increasing the surface area for bacterial adherence and allowing possible evasion of bacteria from the elements of the immune system within this fibrillar structure.