Arfat Jawaid, Masood Akhtar, Farhan Akbar, Muhammad Tahir, Saad Bin Qamar Mirza.
Split-Body Double-Blinded Randomized Controlled Trial of Gelatin foam and Traditional Nasal Pack in Septal Surgery.
Pak J Otolaryngol Jan ;29(1):19-21.

OBJECTIVE: To compare gelatin foam versus traditional nasal pack in terms of pain while in place and on removal. STUDY DESIGN: Split-body, double-blinded (patient and assessor blinded), randomized controlled trial. PLACE AND DURATION OF STUDY: Study was carried out in ENT Departments of Combined Military Hospital (CMH) Bahawalpur, Bahawal Victoria Hospital (BVH) Bahawalpur and CMH Multan from Jun 2009 to Jan 2011. PATIENTS AND METHODS: Patients with symptomatic deviated nasal septum undergoing an elective nasal septal surgery were selected and at the end of surgery one side of nose was packed with a traditional nasal pack (Bismuth iodoform paraffin paste- impregnated ribbon gauze/ paraffin-impregnated ribbon gauze/ paraffin gauze roll) and the other side was packed with gelatin foam. Randomization was done to allot traditional pack or gelatin foam pack to the incision side or non-incision side. The patients were kept blinded about the type of pack placed on each side. RESULTS: There was significantly less pain on removal of gelatin foam (mean pain score 1.35 on a visual analogue pain scale of 0 to 10 cm) as compared to traditional nasal pack (mean pain score 4.11; P=0.01). There was no significant difference in pain score between gelatin foam and traditional pack observed at 6 and 24 hours post-operatively (P=0.08 and 0.77 respectively). Both the packs were equally effective in preventing post-operative haemorrhage and septal hematoma. No crusting and adhesion formation was noted at the end of 2nd and 6th weeks with either of the packs. CONCLUSION: Gelatin foam pack is as effective as a traditional nasal pack in preventing post-operative bleeding and septal haematoma. There is no significant difference in pain due to presence of pack in nasal cavity but Gelatin foam causes significantly less pain on removal. There is no significant crusting and adhesion formation associated with either of these packs.

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