Abstract
Purpose: :
Despite of modern minimally invasive techniques in the treatment of lacrimal stenoses, the external dacryocystorhinostomy remains an essential part of treatment strategies in lacrimal surgery. In addition to the longer hospitalization, patients complain after an external dacryocystorhinostomy about the need and discomfort of nose packing for 48 hours, and the frequent formation of an hematoma or postoperative bleeding, which may necessitate a surgical revision or a deep tamponade.
Methods: :
50 patients were randomized into 2 groups. It should be investigated whether patients can benefit from a replacement of conventional nosepad by an hemostatic agent (FloSeal®). This is a product derived from human plasma, which is also used in cardiac surgery and is in a position to control arterial bleeding of small vessels. Patients' satisfaction, the incidence of bruising and bleeding were evaluated.
Results: :
In the FloSeal® -group the expression of hematomas was smaller than in the group, which was treated with a nosepad. Satisfaction of the FloSeal®-group was significantly higher because that they were not affected by the nosepad. Bleeding, which would have necessitated a new tampon or a surgical revision, did not occur.
Conclusions: :
The treatment with FloSeal® seems to provide a benefit for the patients. The risks caused by potentially contaminated blood products and the high cost of hemostasis by FloSeal® are the disadvantages. So the use of FloSeal® has to be carefully considered in certain cases.
Keywords: lacrimal gland • drug toxicity/drug effects