BACKGROUND: Postoperative bleeding remains a major problem after endoscopic sinus surgery (ESS). Patients who continue to bleed after ESS are at risk of airway compromise from inhalation of blood clots or from aspiration of blood-stained vomitus. The aim of this study was to determine the in vivo efficacy of a novel gel on hemostasis after ESS in a sheep model of chronic rhinosinusitis. METHODS: Twenty-one sheep infested with Oestrus ovus underwent ESS with standardized mucosal injuries created at the anterior ethmoid region using a microdebrider. Immediately after injury a baseline bleeding time was taken using the Boezaart Surgical Field Grading Scale. Computer randomization was performed to either receive chitosan/dextran (CD) gel or no treatment (control). Boezaart bleeding scores were calculated for each side every 2 minutes. Each postoperative day videoendoscopy was performed to document crusting/CD gel dissolution. RESULTS: The CD gel side was significantly more hemostatic at 2, 4, and 6 minutes after injury. Average time to hemostasis was significantly better for the intervention side versus control side, 4.09 (+/-1.61) versus 6.57 (+/-2.20), respectively (p = 0.049). Complete hemostasis occurred by 6 minutes for all CD gel sides; however, control side bleeding was noted on three sides at 8 minutes and on one side at 10 minutes. There was no significant difference in crusts scores at days 1, 3, 7, and 14. CONCLUSION: In the sheep model of ESS, CD gel significantly improved hemostasis compared with the control at 2, 4, and 6 minutes after mucosal injury.
BACKGROUND:Postoperative bleeding remains a major problem after endoscopic sinus surgery (ESS). Patients who continue to bleed after ESS are at risk of airway compromise from inhalation of blood clots or from aspiration of blood-stained vomitus. The aim of this study was to determine the in vivo efficacy of a novel gel on hemostasis after ESS in a sheep model of chronic rhinosinusitis. METHODS: Twenty-one sheep infested with Oestrus ovus underwent ESS with standardized mucosal injuries created at the anterior ethmoid region using a microdebrider. Immediately after injury a baseline bleeding time was taken using the Boezaart Surgical Field Grading Scale. Computer randomization was performed to either receive chitosan/dextran (CD) gel or no treatment (control). Boezaart bleeding scores were calculated for each side every 2 minutes. Each postoperative day videoendoscopy was performed to document crusting/CD gel dissolution. RESULTS: The CD gel side was significantly more hemostatic at 2, 4, and 6 minutes after injury. Average time to hemostasis was significantly better for the intervention side versus control side, 4.09 (+/-1.61) versus 6.57 (+/-2.20), respectively (p = 0.049). Complete hemostasis occurred by 6 minutes for all CD gel sides; however, control side bleeding was noted on three sides at 8 minutes and on one side at 10 minutes. There was no significant difference in crusts scores at days 1, 3, 7, and 14. CONCLUSION: In the sheep model of ESS, CD gel significantly improved hemostasis compared with the control at 2, 4, and 6 minutes after mucosal injury.
Authors: Jaydee D Cabral; Marina Roxburgh; Zheng Shi; Liqi Liu; Michelle McConnell; Gail Williams; Natasha Evans; Lyall R Hanton; Jim Simpson; Stephen C Moratti; Brian H Robinson; Peter J Wormald; Simon Robinson Journal: J Mater Sci Mater Med Date: 2014-08-02 Impact factor: 3.896
Authors: Maggie Chan; Heather J L Brooks; Stephen C Moratti; Lyall R Hanton; Jaydee D Cabral Journal: Int J Mol Sci Date: 2015-06-16 Impact factor: 5.923
Authors: Luis Macias-Valle; Andres Finkelstein-Kulka; Jamil Manji; Christopher Okpaleke; Salahuddin Al-Salihi; Amin R Javer Journal: World J Otorhinolaryngol Head Neck Surg Date: 2018-05-25
Authors: Rajan Sundaresan Vediappan; Catherine Bennett; Clare Cooksley; John Finnie; Markus Trochsler; Ryan D Quarrington; Claire F Jones; Ahmed Bassiouni; Stephen Moratti; Alkis J Psaltis; Guy Maddern; Sarah Vreugde; P J Wormald Journal: PLoS One Date: 2021-01-14 Impact factor: 3.240