FloSeal use in endoscopic sinus surgery: effect on postoperative bleeding and synechiae formation.
OBJECTIVE
The objective of this study is to evaluate the effect of the hemostatic agent, FloSeal (FS), on bleeding and healing after functional endoscopic sinus surgery.


METHODS
We performed randomized, double-blinded, controlled study at a tertiary care center. Patient nasal sides were randomized to FS or control. After completion of sinus surgery, FS was placed in the appropriate nasal cavities followed by saline-soaked neuropatties in both nasal cavities. Control sides received saline-soaked neuropatties alone, without FS.


RESULTS
Forty-five patients were enrolled. Mean time to cessation of bleeding in recovery was 16.4 and 30.8 minutes for the FS- and control-treated sides, respectively (P = .028). Patients maintained diaries for 7 days postoperatively and reported similar durations of bleeding at home, but indicated less discomfort on the FS-treated side. Postoperative endoscopic examinations revealed significantly less crusting in FS-treated nasal cavities at 1 week, but significant difference at 1 and 3 months. There were no differences in postoperative scarring or middle turbinate lateralization.


CONCLUSIONS
Use of FS after functional endoscopic sinus surgery resulted in less bleeding, immediately postoperatively, and less discomfort, and did not increase the incidence of crusting or scarring compared with control.
Jameson
Mark
M
Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, VA, USA.
Gross
Charles W
CW
Kountakis
Stilianos E
SE
D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D004724:Endoscopy; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
C411004:FloSeal Matrix; D006490:Hemostatics