Acute epistaxis management by hemostatic agents a systematic review

Abstract

Background: When compared to nasal packing, the data shows that hemostatic medications are more successful in controlling acute epistaxis. A comprehensive analysis was conducted to assess the effectiveness of topical hemostats in the treatment of epistaxis. Method: Four databases were searched thoroughly for literature. Only admissible observational studies were included. Information retrieved from eight studies included the following: country, rate of short-term and 30-day hemostatic control, patient-reported outcome measures, adverse events, sample size, intervention, treating method, and length of stay in hospital. Results: Eight papers were included in the review when it reached the second stage and satisfied the qualifying requirements. A total of 268 individuals were involved in three cohort and five case series investigations; 232 of them received absorbable intranasal medications. Two investigations on oxidized cellulose compounds and 5 studies on agents that promote the common coagulation pathway were presented. While oxidized regenerated cellulose was inserted endoscopically on the bleeding site in one trial and sutured to the nasal septum in another study, the earlier medicines were applied intranasally. Successful short-term hemostasis was attained in 80% to 100% of patients in 7 out of 8 trials. Patients treated with oxidized regenerated cellulose had considerably lower pain scores than those treated with nasal packing. There were no negative effects linked to the use of intranasal agents in any of the investigations. Conclusion: When compared to nasal packing, the data shows that hemostatic medications are more successful in controlling acute epistaxis.