A Novel Use of Hydrocolloid Dressing as a Packing Material after Functional Endoscopic Sinus Surgery

Background: Functional endoscopic sinus surgery (FESS) is integral in managing chronic rhinosinusitis, often necessitating postoperative nasal packing to mitigate bleeding, clotting, and adhesion risks. However, traditional packings, like Merocel, contribute to patient discomfort and pain during removal. Objective: To compare the outcomes of using hydrocolloid dressing and merocele as a nasal packing after FESS. Patients and Methods: This prospective, single-blinded, randomized controlled study was performed on 60 patients undergoing FESS for chronic rhinosinusitis. They were divided into two groups: one received a hydrocolloid dressing and the other received Merocel packing. Objective assessments included bleeding, adhesions, crusts, mucosal edema, and subjective symptoms, which were rated on Visual Analogue Scales (VAS) for pain, nasal obstruction, and discharge. Endoscopic evaluations were conducted postoperatively at various intervals. Results: The hydrocolloid dressing group demonstrated lower pain scores during early follow-up visits (1 and 2 weeks) and pack removal. Subjective parameters such as discharge, and nasal blockage were generally lower in the hydrocolloid group. The incidence of bleeding was higher in the hydrocolloid group early postoperatively but increased during Merocel removal. The incidence of crust formation favored Merocel at 1 week. Adhesion scores were higher for Merocel at later intervals. Conclusion: Hydrocolloid dressing offers a comfortable alternative to Merocel for nasal packing, reducing pain, blockage, discharge, and complications like adhesions and edema, thus promoting quicker nasal mucosa recovery. However, it carries a higher risk of early postoperative bleeding.