Day-case endoscopic sinus surgery using dissolvable haemostatic nasal packs : a pilot study

In a prospective pilot study, we assessed the efficacy and safety of dissolvable nasal packs (Sinu-knit) for control of post-operative bleeding in patients undergoing endoscopic sinus surgery (ESS), as well as potential complications of this novel packing material and patients' satisfaction with the dissolvable nasal packs. The patients included were considered suitable for a day-case procedure. We excluded subjects under 16-year-old, as well as patients on warfarin or with any coexisting medical or social reasons rendering them unsuitable for a day-case procedure. The main outcome measures were: readmission rate, postoperative bleeding rate, any other postoperative complications and patient satisfaction survey (including management as a day case and views about the packs). Fifteen patients fulfilled our criteria and were enrolled in this study (between March and August 2005). Fourteen patients were able to go home on the same day. One patient stayed overnight because of vomiting. All operations were performed by the same surgeon and the same anaesthetist. There were no readmissions due to postoperative bleeding. All patients were followed up with rigid video-nasendoscopy weekly for three weeks with further reviews at 6 weeks, 3 months and a final follow-up 6 months postoperatively. No postoperative adhesions were seen on nasendoscopy up to 6 months postoperatively. Dissolvable packs appear to be safe and effective and can be used for day case sinus surgery. There is no need for packing removal, thus greater patients' satisfaction.