Use of a Chitosan-Based Hemostatic Dressing in Dacryocystorhinostomy

Abstract

To evaluate the use of a chitosan-based hemostatic dressing (CBHD) (ChitoFlex, HemCon Medical Technologies Inc., Portland, OR, U.S.A.) as an effective adjunct for hemostasis in dacryocystorhinostomy surgery and compare its effectiveness to collagen absorbable hemostat (CAH) (Insat, Johnson & Johnson Gateway, New Brunswick, NJ, U.S.A.). Retrospective, comparative case series. Thirty-five external or endoscopic dacryocystorhinostomy (DCR) and conjuctival dacryocystorhinostomy (CDCR) procedures were performed on 26 patients using the CBHD from May through October 2007. Thirty-five external or endoscopic DCR or CDCR procedures were performed on 27 patients using CAH from February through May 2007. Collection of patient data in the group treated with CBHD included the types of cases performed, surgical outcome, complications, adverse reactions, and telephone follow-up survey of symptomatic results. Collection of patient data in the group treated with CAH primarily focused on the types of cases performed and postoperative bleeding. The main outcome measures were postoperative bleeding and need for anterior nasal packing. Postoperative bleeding occurred in 2 cases in the group treated with CBHD and in 12 cases in the CAH group. The study demonstrates the effectiveness and safety of CBHD as a hemostatic agent in DCR and CDCR and as a promising alternative to CAH.