FloSeal use in endoscopic sinus surgery: effect on postoperative bleeding and synechiae formation

The objective of this study is to evaluate the effect of the hemostatic agent, FloSeal (FS), on bleeding and healing after functional endoscopic sinus surgery.

We performed randomized, double-blinded, controlled study at a tertiary care center. Patient nasal sides were randomized to FS or control. After completion of sinus surgery, FS was placed in the appropriate nasal cavities followed by saline-soaked neuropatties in both nasal cavities. Control sides received saline-soaked neuropatties alone, without FS.

Forty-five patients were enrolled. Mean time to cessation of bleeding in recovery was 16.4 and 30.8 minutes for the FS- and control-treated sides, respectively (P = .028). Patients maintained diaries for 7 days postoperatively and reported similar durations of bleeding at home, but indicated less discomfort on the FS-treated side. Postoperative endoscopic examinations revealed significantly less crusting in FS-treated nasal cavities at 1 week, but significant difference at 1 and 3 months. There were no differences in postoperative scarring or middle turbinate lateralization.

Use of FS after functional endoscopic sinus surgery resulted in less bleeding, immediately postoperatively, and less discomfort, and did not increase the incidence of crusting or scarring compared with control.