Maximizing Postoperative Recovery: The Role of Functional Biomaterials as Nasal Packs-A Comprehensive Systematic Review without Meta-Analysis (SWiM)

Injectable Chitosan Hydrogel Particles as Nasal Packing Materials After Endoscopic Sinus Surgery for Treatment of Chronic Sinusitis

After endoscopic sinus surgery (ESS), nasal packing is often used to stop bleeding and promote wound healing. Because maintaining a moist environment is important to enhance wound healing, hydrogel-based wound dressings are effective to promote wound healing. Chitosan is used in the medical field because of its high hemostatic and wound healing properties. We developed a pH-neutral and non-toxic chitosan hydrogel, which was difficult to achieve using conventional methods. In this study, we show in animal experiments that the chitosan hydrogel (hydrogel particles) had higher wound healing properties than a commercially available solid wound dressing (dry state) composed of the same polymer. Additionally, we applied the injectable chitosan hydrogel particles as nasal packing materials to patients with bilateral chronic sinusitis undergoing ESS in a pilot clinical study. Concerning symptom scores, though the results narrowly missed statistical differences (p < 0.05), the average scores of our chitosan hydrogel were superior to those of a commercially available wound dressing (especially p = 0.09 for nasal bleeding). These findings suggest that the injectable chitosan hydrogel could be a viable option as a packing material following ESS.

Biodegradable Gelatin-Carrageenan Sponges: High-Potential Functional Nasal Packs for Efficient Secretome Delivery

Nasal packing is a critical procedure in postoperative care and trauma management aimed at controlling bleeding, providing structural support, and promoting tissue healing. However, conventional nasal packs often lead to discomfort, infection risks, and secondary tissue damage. To address these challenges, this study explores the potential use of biodegradable and biocompatible gelatin-carrageenan composite scaffolds as an alternative nasal packing material. Five compositions of gelatin-carrageenan scaffolds (ratios 10:0, 7:3, 5:5, 3:7, and 0:10) were fabricated and evaluated for physicochemical properties, hemocompatibility, and cytocompatibility. Results suggest that balanced ratios, such as 7:3 and 5:5, may provide a combination of structural integrity, improved biocompatibility, and controlled degradation, making them a potential candidate for nasal packing applications. The scaffolds exhibited low cytotoxicity and reasonable blood compatibility, which could reduce the risks associated with conventional materials. While these findings are promising, further in vivo studies are necessary to validate the efficacy and safety of these scaffolds in clinical settings. If proven effective, gelatin-carrageenan scaffolds may help address some of the limitations of conventional nasal packing materials and improve postoperative care outcomes.

An Analysis of the VELNEZ Nasal Pack's Acceptability and Safety for Use During Nasal Surgery: A Prospective Study

The primary function of nasal packs is to modulate the bleeding, prevent adhesions and obstruction, with least discomfort to the subjects without risking secondary infection. However, both packing and removal of the pack is an unpleasant experience, with the latter being extremely painful. Therefore the need of the hour is a dressing which prioritizes subject comfort without compromising other desired nasal pack properties. Twenty subjects were enrolled in this interventional, open label study. The subjects had 10 hospital visits, starting from baseline (Visit 1) to postoperative day 28 (Visit 10), at regular intervals. The proportion of the population with postoperative pain alleviation and bleeding control failure (within 10 min) were the main objectives. Within 10 min of VELNEZ administration, all 20 participants got their bleeding under control. With VELNEZ, the painful nasal pack removal method was totally avoided because it was biodegradable. No moderate/severe pain, infection and adhesions were reported in any of the subjects, but few subjects reported moderate obstruction until Visit 3 (Discharge Day). In the present study, for participants undergoing nasal surgery, VELNEZ proved to be a secure and reliable nasal pack. Trial Registration: CTRI/2021/09/036437, prospectively registered.

Biomaterial Material Applications in Postoperative Surgical Fields of Uvulopalatopharyngoplasty: A Comparative Study

This retrospective study compared the effectiveness of different materials used in Uvulopalatopharyngoplasty (UPPP) for snoring or obstructive sleep apnea treatment, focusing on the impact on bleeding control, pain control, and healing ability. The study population comprised 213 patients who underwent UPPP at Wan-Fang Hospital between July 2018 and October 2022 divided into four groups based on the postoperative material used: No Material Use Group, Tissue Glue Group, Platelet-Rich Plasma (PRP) Group, and Polyglycolic Acid (PGA) Sheet Group. Results showed significant differences in operation time and intraoperative bleeding amount among the groups, with the Tissue Glue Group demonstrating the shortest operation time. While no significant differences in postoperative pain at 24 h were observed, PRP and PGA Sheet groups exhibited lower average pain scores in cases with higher pain levels. Postoperative complications and emergency room visits due to pain or bleeding varied among the groups, with the No Material Use Group having the highest incidence, although no statistical significance was achieved. This study provides insights into the potential benefits of using advanced materials in UPPP, guiding future research and clinical practice to improve patient care and outcomes.