EFFECT OF GLOVED VS. PLAIN MEROCEL NASAL PACKING ON POSTOPERATIVE OUTCOMES IN SEPTOPLASTY PATIENTS

Abstract

Background: Nasal packing is essential in septoplasty to stabilize the septum and control bleeding; however, plain Merocel packing often causes discomfort and mucosal trauma. Gloved Merocel, where the sponge is encased in a sterile glove, may reduce these issues, yet evidence is limited.

Objective: To compare the postoperative outcomes of gloved versus plain Merocel nasal packing in patients undergoing septoplasty, focusing on pain, bleeding, adhesion formation, mucosal healing, and mucociliary clearance.

Methods: This randomized controlled trial enrolled 80 patients who underwent septoplasty at Saveetha Medical College and Hospital, Chennai, India. Patients were randomized into Group A (plain Merocel, n=40) or Group B (gloved Merocel, n=40). Outcomes were assessed by a blinded observer: pain via the Visual Analog Scale (VAS) at 24 and 48 hours, bleeding incidence, adhesions via endoscopy at 4 weeks, mucosal healing at 1 and 4 weeks, and mucociliary clearance via saccharin transit time at 1 week. Data were analyzed using t-tests, Mann-Whitney U tests, chi-square tests, or Fisher’s exact tests (p<0.05).

Results: Group B showed significantly lower pain scores at 24 hours (3.2 ± 1.2 vs. 4.8 ± 1.5, p<0.001) and 48 hours (2.1 ± 1.0 vs. 3.5 ± 1.3, p<0.001), reduced bleeding (10% vs. 25%, p=0.042), fewer adhesions (7.5% vs. 20%, p=0.049), faster mucosal healing (10.8 ± 2.1 vs. 12.4 ± 2.3 days, p=0.003), and shorter mucociliary clearance time (15.2 ± 2.9 vs. 18.5 ± 3.2 minutes, p<0.001). Serious adverse events were not observed.

Conclusion: Gloved Merocel nasal packing significantly improves postoperative outcomes by reducing pain, bleeding, and adhesions, while enhancing mucosal healing and mucociliary clearance. This cost-effective modification warrants consideration for its routine use in septoplasty.