Mastoidectomy packs: Xeroform or BIPP?

A retrospective study comparing adverse events using bismuth iodoform paraffin paste (BIPP) and Xeroform as dressings for newly fashioned mastoid cavities after mastoidectomy was undertaken. There were 20 patients in each group. Adverse events were defined as offensive packs, mastoid cavity infections and systemic signs of infection. There were no adverse events using BIPP packs whether or not prophylactic antibiotics were used. Xeroform packs were associated with a significantly higher incidence of adverse events compared to BIPP when using no antibiotic prophylaxis (P less than 0.005) or amoxycillin (P less than 0.005). Adverse events with Xeroform packs were abolished using ciprofloxacin and metronidazole prophylaxis. We conclude that BIPP is the mastoid dressing of choice.