title: Use of Kaolin-impregnated Gauze for Improvement of Intraoperative Hemostasis and Postoperative Wound Healing in Blepharoplasty.
abstract: OBJECTIVE
  Kaolin is a mineral shown to be effective in controlling hemorrhage when combined with standard gauze and applied to wounds. This study investigates the application of kaolin to control intraoperative bleeding and promote wound healing in eyelid surgery.
  
  
  METHODS
  This prospective, randomized, double-blind study recruited patients who underwent eyelid surgery. Following skin incision, kaolin-impregnated gauzewas placed in one eyelid wound bed and cotton gauze in the other, then removed. Distinct, individual areas of bleeding were recorded. Standardized photographs were obtained postoperatively on Day 1, 4, and 7. Photographs were graded for edema and ecchymosis by four blinded observers. Patients also completed a survey inquiring which side had more bruising, swelling, and pain at each return visit.
  
  
  RESULTS
  A total of 46 patients completed the study. The number of intraoperative bleeding sites for kaolin versus plain gauze was not significantly different (p=0.96). Photographic grading by blinded observers did not identify any statistically significant differences in postoperative edema at any time point between lids. There was a statistically significant difference for ecchymosis at postoperative Day 4 (p=0.009) and Day 7 (p=0.016). Patient surveys did not show any difference in perceived edema, ecchymosis, or pain between lids.
  
  
  CONCLUSIONS
  Intraoperative hemostasis was not affected by the use of kaolin-impregnated gauze. The effectiveness of kaolin in wound healing showed improved ecchymosis at Days 4 and 7 when assessed by blinded observers. Patients did not notice any improvement in postoperative edema, ecchymosis, or pain.
authors.affiliation: Department of Ophthalmology, Loyola University Medical Center, Maywood, Illinois;
authors.forename: Srinivas Sai A
authors.initials: SS
authors.lastname: Kondapalli
authors.affiliation: Division of Ophthalmology, Section Oculofacial Plastic and Reconstructive Surgery, Ohio University/OhioHealth Doctor's Hospital, Columbus, Ohio;; Department of Ophthalmology, Oral and Maxillofacial Surgery, Grant Medical Center, Columbus, Ohio;
authors.forename: Craig N
authors.initials: CN
authors.lastname: Czyz
authors.affiliation: Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan;
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Stacey
authors.affiliation: Department of Ophthalmology, Oral and Maxillofacial Surgery, Grant Medical Center, Columbus, Ohio;; Department of Ophthalmology, The Ohio State University, Columbus, Ohio.
authors.forename: Kenneth V
authors.initials: KV
authors.lastname: Cahill
authors.affiliation: Division of Ophthalmology, Section Oculofacial Plastic and Reconstructive Surgery, Ohio University/OhioHealth Doctor's Hospital, Columbus, Ohio;; Department of Ophthalmology, Oral and Maxillofacial Surgery, Grant Medical Center, Columbus, Ohio;; Department of Ophthalmology, The Ohio State University, Columbus, Ohio.
authors.forename: Jill A
authors.initials: JA
authors.lastname: Foster