The Effect of an Expandable Polyvinyl Acetate (Merocel) Pack on the Healing of the Nasal Mucosa of Sheep

2005 ◽  
Vol 19 (6) ◽  
pp. 577-581 ◽  
Author(s):  
David McIntosh ◽  
Allison Cowin ◽  
Damian Adams ◽  
Peter-John Wormald
Keyword(s):  
Nasal Mucosa ◽  
Postoperative Period ◽  
Polyvinyl Acetate ◽  
Healing Process ◽  
Adhesion Formation ◽  
Sinus Surgery ◽  
Time Points ◽  
Significant Difference ◽  
Suitable Animal Model ◽  
And Control

Background There is a lack of knowledge about the healing of the nasal respiratory mucosa after endoscopic sinus surgery (ESS). Nasal packs often are placed after ESS in an attempt to improve hemostasis and reduce adhesion formation. Most nasal packs need to be removed in the postoperative period. This is uncomfortable for the patient and the affect of these packs on the healing process is unknown. Methods We have standardized the sheep as a suitable animal model to examine the healing of the nasal epithelium after ESS. The nasal mucosa of sheep was wounded under endoscopic guidance and either packed with expandable polyvinyl acetate–based pack (Merocel), which was removed at the 5th postoperative day, or left unpacked to serve as control. Serial biopsies of the wounded area were taken every 28 days, up to 112 days postwounding, for examination using light and scanning electron microscopy. Results There was no significant difference in the rate of reepithelialization between the packed and control sides of the sheep (p > 0.05). There was no significant difference in the total amount of surface cilia coverage between the packed and control sides at any time points (p > 0.05). There was no significant difference in the maturity of the cilia between the packed and control sides at any time points (p > 0.05). Conclusion The use of Merocel packing postoperatively neither impairs nor promotes wound healing in the postoperative period.

Optimization of postoperative management of patients undergoing functional endoscopic sinus surgery

2018 ◽  
pp. 26-31
Author(s):  
Sergey Bezshapochny ◽  
Andrey Loburets ◽  
Valery Loburets
Keyword(s):  
Nasal Cavity ◽  
Postoperative Period ◽  
Sodium Hyaluronate ◽  
Sinus Surgery ◽  
Control Group ◽  
Nasal Breathing ◽  
Traditional Therapy ◽  
Significant Difference ◽  
Water Salt ◽  
Experimental Group

Topicality: The result of surgical treatment depends largely on the chosen method of management of the postoperative period, the main purpose of which is to reduce the effects of surgical trauma. Despite the wide variety of drugs for local and systemic use, the question of pharmacotherapy of the operated sinus remains open to this day. The main properties that a modern drug should possess are safety and high clinical efficacy. Aim: to study the clinical efficacy of topical application of a complex preparation based on a saline solution containing sodium hyaluronate and dexpanthenol in patients with chronic sinusitis after functional endoscopic sinus surgery (FESS). Materials and Methods: Clinical and laboratory studies were conducted on 47 patients with chronic rhinosinusitis who underwent surgery using the FESS technique. Patients were divided into 2 groups according to the principle of the postoperative period. Patients of research group (n=21), except for traditional therapy, was used locally NASOMER (a preparation based on a water-salt solution containing sodium hyaluronate and dexpanthenol); to the control group (n=26) patients entered, in the postoperative period received traditional therapy. Traditional therapy included a toilet of the nasal cavity, the use of short-course topical decongestants, irrigation of the nasal cavity with water-salt solutions. Criteria of clinical effectiveness: data of endoscopy of the nasal cavity, rhinomanometry, activity of the mucociliary transport system. The effectiveness of functional research methods in the postoperative period was determined on the 7th and 14th day of treatment. Results: On the 3rd day of the study, an increase in the swelling of the nasal cavity was observed in patients of both clinical groups, correlated with difficulty in nasal breathing. On the 7th day, a decrease in edema was observed in patients of both groups, but in the experimental group, the index of nasal breathing, according to rhinomanometry, was significantly (p<0.05) different from the control group, and was respectively 1.54±0.14 and 2.04±0.19 kPa/l*s. On the 14th day of the study, no significant difference was observed between these indicators. When studying the activity of the ciliated epithelium of the mucous membrane of the nasal cavity, it was proved that patients of the experimental group on day 7 after surgery showed a statistically significant difference in this indicator compared to the control group (17.8±1.0 and 22.7±2.1 min. respectively). Conclusions: The use of NASOMER after surgical intervention in patients with chronic rhinosinusitis contributes to more effective treatment compared with traditional therapy, as evidenced by the rapid recovery of the main functional parameters according to active posterior rhinomanometry and mucociliary clearance. Based on the results of the studies performed, the use of NASOMER for pharmacotherapy in the postoperative period is recommended for patients who have undergone rhinosurgical interventions with the aim of reducing the period of postoperative rehabilitation as an effective anti-inflammatory and wound-healing agent.

scholarly journals Behavior of Cellulose Biosynthetic Membrane as a Peritendinous Implant in Foals

2019 ◽  
Vol 47 (1) ◽  
Author(s):  
Jackson Schade ◽  
Maria Eduarda Gomes das Neves Oliveira ◽  
Renato Silva de Souza ◽  
Ivan Deconto ◽  
William Timboni Teixeira ◽  
...  
Keyword(s):  
Inflammatory Infiltrate ◽  
Histopathological Examination ◽  
Adhesion Formation ◽  
Tendon Injuries ◽  
Cellulose Membrane ◽  
Superficial Digital Flexor Tendon ◽  
Significant Difference ◽  
The Right ◽  
And Control ◽  
Surgically Induced

Background: Tendon injuries are common in horses and are commonly associated with lameness and athletic career disruption. Adhesions formed between the tendons and the surrounding tissues compromise the sliding and movement of the structures, compromising their functionality. Therefore, the control of adhesion formation is critical to restore the structural integrity of the tendon, as well as its biomechanical function. The aim of this study was to evaluate the behavior of the biosynthetic cellulose membrane implanted in foals with surgically induced tendinitis of the superficial digital flexor.Materials, Methods & Results: Six healthy foals were used, which underwent tendinitis induction in the superficial digital flexor of the right and left forelimbs. The lesions was induced by local ischemia by crushing the tendon with hemostatic forceps. The biosynthetic cellulose membranewas implanted only in the right forelimb, involving the superficial digital flexor tendon in the region of the ischemia and the left forelimb was used as control. After surgery, both forelimb were immobilized with synthetic plaster cast for 15 days. Ultrasonography was performed in six foals immediately before (M0), at 15° (M1) at and 30° (M2) day, and three were evaluate at 45° (M3) and 60° (M4) day after surgery. Incisional biopsies were performed in three animals on the 30° day and in three animals on the 60° day after surgery. Histopathological examination involved the analysis of tissue disorganization, presence and type of inflammatory infiltrate and neovascularization, according to the score of 0 to 3. Ultrasonography allowed visualization of the membrane, which was characterized as a continuous hyperechoic line at the edges of the tendon at 15 days (M1). In addition, at 30 and 45 days after surgery, interruption of the hyperechoic line and reduction of echogenicity were observed, and no echogenic lines were observed at 60 days after surgery. During the biopsies, the fragments obtained from the treated limb were presented with easily detachable layers and separate layers of tissue during histological cutting and the slides preparations. There was no significant difference in relation to the histopathological scores between the treated and control member. The inflammatory infiltrate was predominantly of mononuclear cells and fibroblasts, with identification of giant cell in a foal at 30 days. Neovascularization was observed in all limbs, treated and controls at 30 days and in two treated limbs and three control at 60 days. It was possible to identify the synthetic cellulose membrane by histopathology in only two limbs treated at 30 days and in no limb at 60 days.Discussion: The degree of tendonitis induced in the present study was considered mild according to ultrasonographic analysis at 15 days after surgery. This fact limited the evaluation of the biosynthetic cellulose membrane in the prevention of adhesions, since they were not observed in both groups. However, the ability of the membrane to minimize adhesion formation can be suggest by the macroscopically observed individualization of the tissue layers during histological sections and slides preparation. Ultrasonographic analysis allowed the visualization of the membrane, as well as its positioning and the absorption process. Therefore, ultrasonography can be used in post-implantation monitoring of the membrane. The comparison of the histopathological scores demonstrates the biocompatibility of the biosynthetic cellulose membrane when implanted in foals submitted to surgically induced tendinitis, since there was no difference when compared to treated and control limbs. Therefore, it can be used safely in the treatment of tendon injuries in horses.

scholarly journals Assessment of Nasal Airflow and Pain, Safety and Cost of an Improvised Nasal Airway (Nasogastric) Tube After Endoscopic Sinus Surgery

2020 ◽  
Vol 35 (2) ◽  
pp. 22
Author(s):  
Josephine Grace Rojo ◽  
Rachel Zita Ramos
Keyword(s):  
Pain Score ◽  
Postoperative Period ◽  
Nasogastric Tube ◽  
Endoscopic Sinus Surgery ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Nasal Airway ◽  
Nasal Airflow ◽  
Significant Difference ◽  
Group A

ABSTRACT Objective: To compare subjective nasal airflow and overall pain score (as well as safety and added cost of) using an improvised nasal airway tube (nasogastric tube) versus nasal packing after endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods:Design: Quasi - Experimental Prospective Cohort StudySetting: Tertiary Government Training HospitalParticipants: Twenty-six (26) consecutive patients aged 18 to 77 years old diagnosed with CRSwNP who underwent ESS were alternately assigned to an experimental group (A) of 13, where an improvised nasal airway (nasogastric) tube was placed in addition to the nasal pack or a control group (B) of 13 with nasal packing alone. Results: There was a significant difference in subjective nasal airflow between experimental (A) and control (B) groups during the immediate postoperative period where the mean subjective airflow was 8.07 and 0.00 over 10.00, respectively. No significant difference was noted between the groups in terms of age, gender, severity of polyposis and overall pain score. No complications such as bleeding, Toxic Shock Syndrome, vestibular or alar injury and septal necrosis were noted immediately post-op and after one week follow-up in both groups. An approximate cost of PhP 25 was added to group A. Conclusion: An improvised nasal airway using a nasogastric tube provides adequate airflow without additional pain in the immediate postoperative period. It is safe to use and an affordable option for patients in need of nasal airway stents residing in areas where a preformed nasal packing with incorporated tube stent is not available.

scholarly journals The Effects of Postoperative Astaxanthin Administration on Nasal Mucosa Wound Healing

2019 ◽  
Vol 8 (11) ◽  
pp. 1941 ◽  
Author(s):  
Manciula ◽  
Berce ◽  
Tabaran ◽  
Trombitaș ◽  
Albu
Keyword(s):  
Wound Healing ◽  
Cell Count ◽  
Nasal Mucosa ◽  
Goblet Cell ◽  
Healing Process ◽  
Sinus Surgery ◽  
Control Group ◽  
Wound Healing Process ◽  
Post Injury ◽  
Subepithelial Fibrosis

. Background: Wound healing of the nasal mucosa after endoscopic sinus surgery (ESS) is frequently complicated by scaring and consequently recurrences are encountered. Methods of optimizing results have been sought. In the present study we evaluated the effects of a powerful antioxidant, astaxanthin, on nasal mucosa healing after surgery, comparing it to the extensively studied properties of dexamethasone. Materials and Methods: 63 Wistar rats were used. The nasal mucosa from one side was damaged employing the brushing method. They were randomly divided into three experimental groups, one treated with astaxanthin, the second treated with dexamethasone and the third one acted as the control and was given normal saline. The rats were killed on days 5, 14 and 28 following injury. We observed the temporal evolution of the wound healing process and quantified the results by assessing four parameters: the epithelial thickness index (ETI), the subepithelial thickness index (STI), the goblet cell count and the subepithelial fibrosis index (SFI). Results: At 28 days, the ETI was significantly lower in the astaxanthin group (p < 0.05) compared to the other two groups. The STI was also lower in the astaxanthin group (p < 0.05), but comparable to the dexamethasone group at 28 days. The goblet cell count was higher in the astaxanthin group. The SFI had similar results in both dexamethasone and astaxanthin groups, with lower values compared to the control group. In the astaxanthin group there was no synechia formation. Conclusion: Astaxanthin given in the post injury period significantly decreases fibrosis, inhibits synechia development and significantly decreases subepithelial fibrosis. Moreover, it has no general or local toxic effects.

scholarly journals Postsurgical rehabilitation of patients with chronic rhinosinusitis

2020 ◽  
pp. 74-79
Author(s):  
Sergey B. Bezshapochny ◽  
Valery V. Loburets ◽  
Andrey V. Loburets ◽  
O.R. Dzhirov
Keyword(s):  
Chronic Rhinosinusitis ◽  
Postoperative Period ◽  
Healing Process ◽  
Functional Anatomy ◽  
Endoscopic Examination ◽  
Nasal Discharge ◽  
Significant Difference ◽  
Clinical Advantage ◽  
Endoscopic Score ◽  
Based Medicine

Topicality: Modern rhinosurgery in tht treatment of chronic rhinosinusitis based of tht principles of maximum preservation of the functional anatomy of the nasal cavity. This helps to improve not only the healing process but also tht quality of life of the patient. Functional endoscopic surgery (FESS) is tht most effective treatment lor chronic rhinosinusitis today. This method helps to accelerate the recovery of patients and reduce the number of postoperative complications, which in turn reduces the need lor surgery. But apart from meticulous and careful surgical technique, one of the most important places in the treatment of the patient is optimal management after surgery, for maximum potentiating of recovery. The relevance of the study is due to the need to further improve the pharmacotherapy of the postoperative period. This article high lights several different therapies aimed at the fast test restoration of the physiological work of the nasal structures. Materials and methods: In total, 50 patients were divided into three groups as part of the study. Group 1 received an isotonic solution of 0.9% NaCl from day one and topical glucocorticosteroids (Mometasone furoate) from day 7. In group 2A, phytopreparation was added to classic therapy and 0.9% NaCl was used instead of the standard saline solution, with 0.4% CO2 added. Evaluation of the effectiveness of treatment was performed using a visual-analog scale lor subjective symptoms and endoscopic examination using the scale of The Modified Lund-Kennedy Endoscopic Score lor objective symptoms. Results: On the 7th day, statistically significant differences were observed according to VAS data between patients of the 1st and 2B groups in terms of nasal discharge (p<0.05, U=77.5) and impaired olfactory function (p<0.05, U=75), in the same period a statistically significant difference was observed between MLK indices in patients of 1st and 2B groups (p<0.05, at U=73) No side effects of the drugs used in the study were detected. Conclusion: Based on the study, it can be concluded tht the use in the postoperative period of the proposed drugs have a significant clinical advantage, which is based of clinical studies and confirmed by the principles of evidence-based medicine.

Effect of topical 0.5% tetracaine hydrochloride on intraocular pressure in ophthalmologically normal cats

2021 ◽  
pp. 1098612X2110059
Author(s):  
Houman Faghihi ◽  
Seyed Mehdi Rajaei ◽  
Hesam Ostadhasan ◽  
Hannah Emami Alagha
Keyword(s):  
Intraocular Pressure ◽  
Artificial Tears ◽  
Control Groups ◽  
Time Points ◽  
Rebound Tonometer ◽  
Significant Difference ◽  
Baseline Values ◽  
The Mean ◽  
And Control

Objectives The aim of this study was to assess the effect of topical tetracaine hydrochloride 0.5% on intraocular pressure (IOP) in ophthalmologically normal cats. Methods Twenty domestic shorthair cats (40 eyes) were used in this study. Each cat was randomly allocated to one of two groups (treatment or control). Baseline IOP (T0) was measured in each cat, and then one drop of tetracaine hydrochloride 0.5% or artificial tears was administered into a randomly chosen eye of each cat in the treatment and control groups, respectively. Repeat IOP measurements were performed at 2 mins (T2), 5 mins (T5), 15 mins (T15) and 30 mins (T30) with a rebound tonometer. Results Mean baseline IOP in all eyes was 20.6 ± 2.5 mmHg. After the unilateral administration of tetracaine, mean IOP decreased significantly in the treated eye at T2 ( P = 0.01). Mean IOP returned to baseline values at T15. The mean IOPs in the treated eyes at T0, T2, T5, T15 and T30 were 20.6 ± 3.3 mmHg, 18.2 ± 2.5 mmHg, 18.2 ± 3.4 mmHg, 20.2 ± 3.2 mmHg and 19.8 ± 2.7 mmHg, respectively. A significant difference in IOP was found at all time points between the tetracaine and control groups (P <0.03). Conclusions and relevance The results of the present study showed a statistically significant reduction in mean IOP 2 mins after the administration of tetracaine hydrochloride 0.5% in the treated eyes of the cats.

scholarly journals Comparison of Absorbable Packing versus No Packing in Wound Healing after Endoscopic Sinus Surgery: A Systematic Review and Pooled Analysis

ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Zhenxiao Huang ◽  
Bing Zhou
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Endoscopic Sinus Surgery ◽  
Adhesion Formation ◽  
Pooled Analysis ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Cochrane Library ◽  
Significant Difference ◽  
Mucosal Edema

<b><i>Introduction:</i></b> Nasal packing after endoscopic sinus surgery (ESS) is controversial. The aim of this systematic review was to compare absorbable packing versus no packing in wound healing after ESS for the treatment of chronic rhinosinusitis. <b><i>Data Source:</i></b> English electronic databases, including Cochrane Library, EMBASE, MEDLINE, and PubMed, were searched, and only randomized controlled trials were included. <b><i>Methods:</i></b> The outcome measures were the presence of synechiae/adhesion formation, mucosal edema, crusting, granulation formation, and infection. The McNemar’s test was used for pooled analysis. <b><i>Results:</i></b> Four studies with 148 participants were included. The pooled analysis showed that absorbable packing may offer benefit in reducing adhesion at 6–8 weeks (odds ratio [OR]: 0.3864; 95% confidence interval [CI]: 0.2136–0.7235) and 12 weeks (OR: 0.2396, 95% CI: 0.08267–0.7709) postoperatively compared with no packing. There was no significant difference between the packed and the unpacked side at 2, 6–8, and 12 weeks after ESS in terms of presence of crusting, edema, and granulation formation. <b><i>Conclusion:</i></b> There is insufficient evidence to suggest that absorbable packing after ESS does not increase mucosal edema, granulation formation, and infection. However, the absorbable packing may be more effective than no packing for the prevention of mucosal adhesion after ESS. The use of absorbable nasal packing after ESS is recommended when used to reduce postoperative mucosal adhesion. More research in this area is clearly needed.

scholarly journals Concentrations of H1-Receptor Antagonist in the Human Nasal Mucosa

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Kenji Takasaki ◽  
Kaori Enatsu ◽  
Hidetaka Kumagami ◽  
Haruo Takahashi
Keyword(s):  
Allergic Rhinitis ◽  
Receptor Antagonist ◽  
Nasal Mucosa ◽  
High Performance ◽  
University Hospital ◽  
Sinus Surgery ◽  
H1 Receptor ◽  
Group I ◽  
Significant Difference ◽  
H1 Receptor Antagonist

Aims. To measure blood and tissue concentrations of the H1-receptor antagonist, bepotastine besilate (BB).Methods. Participants included 14 men and six women, whose age ranged from 13 to 76 years, with chronic rhinosinusitis, who underwent endoscopic sinus surgery at our university hospital. Among them, 10 participants had allergic rhinitis (AR) (Group I), and others did not have AR (Group II). Nasal mucosa and blood were collected 55 to 130 minutes after oral administration of BB 10 mg. Concentrations of the agent in the serum and nasal mucosa were measured by high-performance liquid chromatography.Results. Concentrations of BB of the serum in Group I and II were  ng/mL and  ng/mL. Those of the nasal mucosa tissue in Groups I and II were  ng/g and  ng/g. There was no significant difference in the values of concentration of BB between the serum and the nasal mucosa in either Group I or II ( and , resp., Pairedt-test).Conclusion. This preliminary study is considered the first report on the concentration of H1-receptor antagonists in nasal mucosa. The prompt absorption and transition to the nasal mucosa of BB seems to have an effect on allergic rhinitis.

The Effect of a Hyaluronic Acid–Based Nasal Pack on Mucosal Healing in a Sheep Model of Sinusitis

2005 ◽  
Vol 19 (6) ◽  
pp. 572-576 ◽  
Author(s):  
Suresh P. Rajapaksa ◽  
Allison Cowin ◽  
Damian Adams ◽  
Peter-John Wormald
Keyword(s):  
Hyaluronic Acid ◽  
Chronic Sinusitis ◽  
Adhesion Formation ◽  
Mucosal Healing ◽  
Sinus Surgery ◽  
Lateral Nasal Wall ◽  
Sheep Model ◽  
Nasal Pack ◽  
Significant Difference ◽  
Clinically Significant

Background A hyaluronic acid–based nasal pack has been shown previously to have a beneficial effect on mucosal healing in a healthy sheep model. However, endoscopic sinus surgery (ESS) usually is performed in the presence of infection and inflammation. The aim of this study was to examine the efficacy of hyaluronic acid–based nasal packing on mucosal healing in a sheep model of chronic sinusitis. Methods A standardized sheep model of chronic sinusitis was used. Full-thickness mucosal injuries were performed under endoscopic guidance with a microdebrider. Adjacent wounds were created between the lateral nasal wall and the ethmoid turbinate. Then, the injuries were either packed with a dissolvable hyaluronic acid–based pack or left unpacked to serve as a control. Serial biopsies of the healing mucosa were performed at days 28, 56, 84, and 112 postsurgery, and the presence or absence of adhesions between the ethmoid turbinate and lateral nasal wall was noted. The biopsy specimens were assessed for reepithelialization and epithelial height using light microscopy, and for reciliation using scanning electron microscopy. Results There was no significant difference in reepithelialization or relative epithelial height between the packed sides and the control sides at any time point. There was a statistically significant difference in reciliation between the two groups at day 112 but this was not deemed clinically significant. The packing had no significant effect on adhesion formation. Conclusion In the sheep model of chronic sinusitis, a dissolvable hyaluronic acid–based pack did not have any significant effect on mucosal healing or adhesions formation after ESS, as assessed by examining reepithelialization, epithelial height, reciliation, and the presence of adhesions.

scholarly journals The effect of 3% binahong leaf extract gel on the wound healing process of post tooth extraction

2021 ◽  
Vol 54 (2) ◽  
pp. 57
Author(s):  
Olivia Avriyanti Hanafiah ◽  
Diana Sofia Hanafiah ◽  
Rahmi Syaflida
Keyword(s):  
Wound Healing ◽  
Tooth Extraction ◽  
Leaf Extract ◽  
Healing Process ◽  
Control Group ◽  
Wound Healing Process ◽  
Herbaceous Plant ◽  
Significant Difference ◽  
Analyse Data ◽  
And Control

Background: One of the common frequently performed procedures in dentistry is tooth extraction. After tooth extraction, a series of biological events occurs in the alveolar socket that ultimately results in healing of the socket. Binahong (Anredera cordifolia) is an herbaceous plant that contains active compounds that may accelerate the wound healing process. Purpose: The aim of this study is to investigate the effect of 3% binahong leaf extract gel on the healing process of the postextraction wound. Methods: 3% binahong leaf extract gel was prepared with the composition of 1 g carbopol, 1 g hydroxypropilmethylcellulose (HPMC), 4 g glycerin, 3 g triethanolamine (TEA), 0.04 g Nipagin, 0.04 g Nipasol, 1.2 g binahong leaf extract and Aq ad 40 g. A total of 18 people were subjected to tooth extraction and were then divided into two groups, with nine people in the binahong group and nine in the control group. Following that, residual socket volume (RSV) was examined on days 3, 7 and 14 after the extraction in both the binahong and control groups. The RSV value was obtained by calculating the mesiodistal x bucolingual width x the depth probing and measured using a calliper and probe. Repeated analysis of variance (ANOVA) and Friedman test followed by Wilcoxon and dependent t-test (p<0.05) were used to analyse data. Results: Significant difference in the mean RSV between the control and binahong groups was observed on days 3, 7 and 14 post tooth extraction. The RSV value in the binahong group was lower when compared to the control group (p <0.05). Conclusion: 3% binahong leaf extract gel can accelerate the process of healing socket wounds.

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