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The effect of the duration of merocel in a glove finger on postoperative morbidity
Saban Celebi1, Erdem Caglar, Omer N Develioglu
1Department of Otolaryngology, Taksim Education and Research Hospital, Istanbul, Turkey. celebisaban@hotmail.com
Abstract:
We examined the effects of the duration of keeping a Merocel nasal packing in the nose and the application technique (packing applied either directly or inside a glove finger) on postoperative morbidity and complications. The study included 129 patients (67 males and 62 females; age range 18 to 56 years) undergoing nasal septoplasty without turbinate intervention. The patients were randomly assigned into 4 groups. In group 1 and group 2, Merocel was directly applied in the nasal cavity for 24 hours and 48 hours, respectively; in group 3 and group 4, Merocel was kept in the nasal cavity in a powder-free glove finger for 24 hours and for 48 hours, respectively. Pain and discomfort scores were evaluated by a visual analog scale. The time taken between removal of the tampon and when the patients began to breathe comfortably was called the nasal obstruction time. The differences in mean discomfort score between the groups were not statistically significant (P > 0.05), while the mean pain scores were statistically higher in groups 1 and 2 than in groups 3 and 4 (P < 0.05). The nasal obstruction time was statistically shorter in groups 2 and 4 than in groups 1 and 3 (P < 0.05). Therefore, keeping Merocel inside a glove finger in place for 48 hours notably reduces the pain occurring during the removal of the nasal tampon. It also reduces nasal obstruction time and prevents synechia, leakage, bleeding, and septal hematoma, without compromising patient comfort.
Insights
Applying Merocel nasal packing within a glove finger for 48 hours significantly reduces pain and nasal obstruction time post-surgery. This method also prevents complications like bleeding and hematoma, enhancing patient recovery.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Patient Outcomes
Background:
- Nasal packing is crucial after septoplasty to control bleeding and support nasal structures.
- Merocel is a common material for nasal packing, but its application method and duration can influence patient experience and complications.
Purpose of the Study:
- To evaluate the impact of Merocel nasal packing duration (24 vs. 48 hours) and application technique (direct vs. glove finger) on postoperative morbidity.
- To identify optimal Merocel packing parameters for minimizing pain, discomfort, and complications after nasal septoplasty.
Main Methods:
- A randomized study involving 129 patients undergoing nasal septoplasty.
- Four groups were established based on Merocel packing duration (24h/48h) and application method (direct/glove finger).
- Pain, discomfort (Visual Analog Scale), and nasal obstruction time were assessed post-removal.
Main Results:
- No significant difference in patient discomfort scores across all groups.
- Significantly lower pain scores in the glove finger groups (48h) compared to direct application.
- Shorter nasal obstruction times observed with 48-hour packing (both direct and glove finger) compared to 24-hour packing.
Conclusions:
- Applying Merocel nasal packing within a glove finger for 48 hours is superior in reducing postoperative pain and nasal obstruction time.
- This technique effectively minimizes complications such as synechia, leakage, bleeding, and septal hematoma.
- The 48-hour glove finger method offers improved patient recovery without compromising comfort.