One-day versus 5-day head bandage after mastoid surgery: a randomized-control double-blinded clinical trial

Abstract Aim To compare 1-day versus 5-day mastoid pressure bandages after mastoid surgeries. Methods In a randomized-control double-blinded clinical trial conducted at a tertiary referral hospital, we enrolled adult patients with uncomplicated chronic suppurative otitis media who underwent mastoid surgeries. We included 150 consecutive patients who were assigned to one of the following groups: group A of 75 cases with a 1-day mastoid bandage and group B of 75 cases with a 5-day mastoid bandage. The primary outcome was wound-related complications: hematoma, seroma, and infection. The secondary outcome was mastoid bandage pressure-related complications: pain/headache, eye swelling, skin maceration, and skin ulcers and scars. Results In group A, we reported hematoma in 4% of the cases and seroma in 1%, while in group B, we found wound infection in 2% of the cases. This difference between both groups was statistically insignificant. In group B, we documented head ulcers in 34% of the cases, skin maceration in 23%, and eye swelling in 12%. The difference between both groups was statistically significant. The median visual analogue score was 5.0 and 6.0 for groups A and B, respectively. There was a statistically significant difference between both groups, with a higher score in the 5-day mastoid dressing group. Complications were strongly associated with older age, smoking, hypertension, and atherosclerosis. Conclusion A shorter 1-day dressing protocol may be more advantageous compared to a longer 5-day protocol in terms of reducing postoperative headache/pain and complication rates while posing no significant risk of hematoma or seroma formation.