The effectiveness of postoperative intervention in patients after rhinoplasty: a meta-analysis

Rhinoplasty is the most common facial plastic surgical procedure, and the occurrence of periorbital edema and ecchymosis is normal after rhinoplasty. The goal of this study was to perform a systematic review with meta-analysis of the efficacy of postoperative care of edema and ecchymosis following rhinoplasty. Two authors independently searched the databases (PubMed, SCOPUS, Embase, Web of Science, and the Cochrane database) from inception to September 2016. We included studies that compared postoperative care methods (intervention groups) with no treatment (control group) where the outcomes of interest were edema, ecchymosis, and satisfaction rate of patients on postoperative days. Sufficient data for meta-analysis were retrieved for 11 trials with a total of 627 patients. Eyelid edema and ecchymosis during the first 7 days postoperatively were statistically decreased in the arnica administration groups versus the control group. Eyelid edema and ecchymosis during the first 24 h postoperatively were statistically decreased in the cold compression group versus the control group. The ratio of patient satisfaction was statistically higher in the tapping application group than in the control group. However, the analysis indicated that surgeons had a significant tendency to decrease intranasal packing. The administration of arnica, cold compression, and tape could reduce eyelid edema and ecchymosis. Intranasal packing was associated with more adverse effects in terms of postoperative ecchymosis compared to non-packing. However, additional trials with thorough research methodologies should be conducted to confirm the results of this study.