J Korean Ophthalmol Soc.  2015 May;56(5):656-663. 10.3341/jkos.2015.56.5.656.

The Clinical Efficacy of Cutanplast(R) Nasal Packing after Endonasal Dacryocystorhinostomy

• Kim YJ
• Yang JW

• KMID: 2121161
• DOI: http://doi.org/10.3341/jkos.2015.56.5.656

Abstract

PURPOSE
The purpose of this study was to investigate the clinical efficacy of Cutanplast(R) nasal packing after endonasal dacryocystorhinostomy.
METHODS
The present study included a total of 76 adult patients (98 eyes) with primary acquired nasolacrimal duct obstruction who underwent endonasal dacryocystorhinostomy. Fifty-four eyes were packed with Cutanplast(R) and 44 eyes were packed with Merocel(R). Patient discomfort while the packing was in situ, degree of bleeding during the day after operation, functional and anatomical success rate, and postoperative complications such as synechiae, granulation, wound healing (osteal mucosal epithelium epithelization), and revision rate were compared between the packing materials.
RESULTS
The Cutanplast(R) was significantly more comfortable and effective at preventing hemorrhage after endonasal dacryocystorhinostomy during the day following the operation. There was no significant difference between the two groups in postoperative anatomical and functional surgical success rate at 1 week, 1 month and 3 months. In comparison with postoperative complications, the Cutanplast(R) group showed a lower incidence of delayed wound healing (delayed epithelialization of the osteal mucosal epithelium) than the Merocel(R) group, whereas there was no difference in granulation, synechiae, or revision rate.
CONCLUSIONS
The Cutanplast(R) nasal pack resulted in significantly less discomfort and less bleeding compared to the Merocel(R) nasal pack. Moreover, the Cutanplast(R) showed a lower proportion of delayed wound healing after endonasal dacryocystorhinostomy and had the advantage of low cost compared to other hemostatic nasal packing materials. Therefore, Cutanplast(R) nasal packing after endonasal dacryocystorhinostomy can be considered a comfortable, cost-effective and clinically-effective method.

Keyword

Absorbable nasal packing; Cutanplast(R); Endonasal dacryocystorhinostomy; Wound healing

MeSH Terms

Adult
Dacryocystorhinostomy*
Epithelium
Hemorrhage
Humans
Incidence
Nasolacrimal Duct
Postoperative Complications
Wound Healing

Figure

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  Figure 1. (A) The Cutanplast® is prepared by dividing it into four pieces. (B) Cutanplast® folded in half is inserted through the nose and (C) packed into the middle meatus. Several Cutanplast® are further inserted.

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  Figure 2. Endoscopic findings of the middle meatus after endonasal dacryocystorhinostomy with Cutanplast® packing. (A), (B) Liquefied hemostatic gelatin sponge (Cutanplast®) 1 week after application and can be gently removed by a suc-tion device. (C) Normal epithelization of the osteal mucosal epithelium with a silicone tube at 2 months. (D) Normally recovered epithelization of the osteal mucosal epithelium when the silicone tube removed at 3 months. C = liquefied Cutanplast®; NS = nasal septum; MT = middle turbinate; ST = silicone tube. * Osteal opening.

Reference

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