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Mastoidectomy packs: Xeroform or BIPP?
E B Chevretton1, R D McRae, J B Booth
1Department of ENT Surgery, Royal London Hospital, Whitechapel, London.
The Journal of Laryngology and Otology
|November 1, 1991
Summary
Bismuth iodoform paraffin paste (BIPP) is the superior mastoid dressing compared to Xeroform. BIPP demonstrated no adverse events, while Xeroform showed higher infection rates without antibiotic prophylaxis.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Infection Control
Background:
- Mastoidectomy creates cavities requiring dressings.
- Choosing the optimal dressing is crucial for preventing complications.
- Bismuth iodoform paraffin paste (BIPP) and Xeroform are common choices.
Purpose of the Study:
- To compare adverse events associated with BIPP and Xeroform mastoid dressings.
- To evaluate the impact of antibiotic prophylaxis on dressing-related complications.
Main Methods:
- Retrospective study of 40 patients (20 per group) undergoing mastoidectomy.
- Comparison of adverse events: offensive packs, mastoid infections, systemic infections.
- Analysis of outcomes with and without prophylactic antibiotics (amoxicillin, ciprofloxacin, metronidazole).
Main Results:
- BIPP packs showed no adverse events, regardless of antibiotic use.
- Xeroform packs had significantly higher adverse events than BIPP without prophylaxis (P<0.005).
- Adverse events with Xeroform were eliminated with ciprofloxacin and metronidazole prophylaxis.
Conclusions:
- Bismuth iodoform paraffin paste (BIPP) is the preferred mastoid dressing.
- Xeroform is associated with a higher risk of adverse events, particularly without adequate antibiotic coverage.