Document Detail


The efficacy of a novel chitosan gel on hemostasis after endoscopic sinus surgery in a sheep model of chronic rhinosinusitis.
MedLine Citation:
PMID:  19379616     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Postoperative bleeding remains a major problem after endoscopic sinus surgery (ESS). Patients who continue to bleed after ESS are at risk of airway compromise from inhalation of blood clots or from aspiration of blood-stained vomitus. The aim of this study was to determine the in vivo efficacy of a novel gel on hemostasis after ESS in a sheep model of chronic rhinosinusitis.
METHODS: Twenty-one sheep infested with Oestrus ovus underwent ESS with standardized mucosal injuries created at the anterior ethmoid region using a microdebrider. Immediately after injury a baseline bleeding time was taken using the Boezaart Surgical Field Grading Scale. Computer randomization was performed to either receive chitosan/dextran (CD) gel or no treatment (control). Boezaart bleeding scores were calculated for each side every 2 minutes. Each postoperative day videoendoscopy was performed to document crusting/CD gel dissolution.
RESULTS: The CD gel side was significantly more hemostatic at 2, 4, and 6 minutes after injury. Average time to hemostasis was significantly better for the intervention side versus control side, 4.09 (+/-1.61) versus 6.57 (+/-2.20), respectively (p = 0.049). Complete hemostasis occurred by 6 minutes for all CD gel sides; however, control side bleeding was noted on three sides at 8 minutes and on one side at 10 minutes. There was no significant difference in crusts scores at days 1, 3, 7, and 14.
CONCLUSION: In the sheep model of ESS, CD gel significantly improved hemostasis compared with the control at 2, 4, and 6 minutes after mucosal injury.
Authors:
Rowan Valentine; Theo Athanasiadis; Stephen Moratti; Simon Robinson; Peter-John Wormald
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American journal of rhinology & allergy     Volume:  23     ISSN:  1945-8924     ISO Abbreviation:  Am J Rhinol Allergy     Publication Date:    2009 Jan-Feb
Date Detail:
Created Date:  2009-04-21     Completed Date:  2009-05-26     Revised Date:  2011-11-10    
Medline Journal Info:
Nlm Unique ID:  101490775     Medline TA:  Am J Rhinol Allergy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  71-5     Citation Subset:  IM    
Affiliation:
Department of Surgery-Otorhinolaryngology, Head and Neck Surgery University of Adelaide, Adelaide, Australia.
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MeSH Terms
Descriptor/Qualifier:
Administration, Intranasal
Animals
Chitosan / administration & dosage*
Disease Models, Animal
Endoscopy / methods*
Ethmoid Sinusitis / surgery*
Gels
Hemostasis, Endoscopic / methods*
Hemostatics / administration & dosage
Otorhinolaryngologic Surgical Procedures / methods*
Postoperative Hemorrhage / therapy*
Rhinitis / surgery*
Sheep
Video Recording
Chemical
Reg. No./Substance:
0/Gels; 0/Hemostatics; 9012-76-4/Chitosan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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