title: Randomized controlled trial comparing Merocel and RapidRhino packing in the management of anterior epistaxis.
abstract: OBJECTIVE
  A prospective non-blinded randomized controlled trial to compare the efficacy of Merocel and RapidRhino nasal packs in the treatment of anterior epistaxis.
  
  
  METHODS
  Fifty-two consecutive participants admitted with anterior epistaxis refractory to digital pressure or nasal cautery were randomized to treatment using one or other of the nasal packs. Patients who required repacking because of continued bleeding, only the first packs were included in the analysis. Haemostatic properties of the packs were measured by grading bleeding during and after removal of the pack (0-4, where four is uncontrollable) and by noting if the nose was re-packed or not. The difficulty of insertion and removal (graded 0-3 by clinician where 3 is the most difficult) and the participant's perception of discomfort (graded 0-10, where 10 is the worst pain) during insertion and removal of the pack were also measured.
  
  
  RESULTS
  For bleeding, the mean values for Merocel and RapidRhino during packing and after pack removal were not significant (P = 0.38 and 0.82 respectively). The mean values of patient discomfort on insertion were 6.9 and 5.0 (P = 0.01), and for discomfort on removal were 4.6 and 3.4 (P = 0.05) respectively. The mean values of insertion graded by the clinician were 1.7 and 0.9 (P = 0.0003), and for removal were 1.4 and 0.4 (P < 0.0001).
  
  
  CONCLUSIONS
  RapidRhino and Merocel are equally effective in the control of anterior epistaxis but RapidRhino is significantly more comfortable for the patient and easier for the healthcare worker during insertion and removal.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Blackburn Royal Infirmary, Lancashire, UK.
authors.forename: K
authors.initials: K
authors.lastname: Badran
authors.forename: T H
authors.initials: TH
authors.lastname: Malik
authors.forename: A
authors.initials: A
authors.lastname: Belloso
authors.forename: M S
authors.initials: MS
authors.lastname: Timms
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004844:Epistaxis / Q000628:therapy*; D005260:Female; D005557:Formaldehyde / Q000627:therapeutic use*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011142:Polyvinyl Alcohol / Q000627:therapeutic use*; D013630:Tampons, Surgical; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics; D005557:Formaldehyde; C027490:polyvinyl alcohol formaldehyde foam; D011142:Polyvinyl Alcohol