الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
To compare the differences in the outcome of the technique of quilting sutures of septal mucosal flaps as opposed to vaseline gauze nasal packing, and merocel nasal packing after septoplasty regarding:
I. Post-operative nasal symptoms.
II. Need for post-operative analgesia.
III. Post-operative healing as judged by endoscopic examination.
Patients and methods
Sixty three patients (aged 18-50 years) scheduled for nasal septal surgery were included. Following surgery, three types of nasal packing systems were utilized: (1) Vaseline gauze (group A: 21 patients); (2) a Merocel standard 8-cm nasal dressing without airway (group B: 21 patients); (3) quilting suture of the septal mucosal flaps (group C: 21 patients) to the patients. Post-operative facial pain/headache, discomfort from packing removal, need for analgesia, post-operative blood loss, infection, hematoma, crusting, granulation tissue, synechiae formation and mucosal changes were evaluated.
Results
The difference among post-operative pain of the three groups was statistically significant (p<0.05).
The vazeline gauze and merocel nasal packings were found to be significantly more painful than quilting suture during postoperative 48 hours (p<0.05) and the discomfort from the nasal packing removal had avoided in cases of quilting suture of the septal mucosal flaps. The analgesic requirements for postoperative pain and discomfort were less in cases of quilting suture. There were no statistically significant differences in regards the postoperative bleeding, infection, hematoma, crusts, granulation tissue, synechiae formation and mucosal changes among the three groups (p>0.05).
Conclusion
The use of quilting suture technique is a useful and highly appreciated alternative to the nasal packing after septoplasty.
In our prospective randomized study, it was demonstrated that postoperative pain was so mild with quilting suture that even in some cases no analgesic medication was necessary and there were no differences between the nasal packing and the quilting suture of the septal mucosal flaps in regards the postoperative complications including hematoma formation, infection, synchia, crustation, granulation tissue and mucosal changes. Therefore, it can be concluded that quilting suture of the septal mucosal flaps is not only a reliable technique to prevent bleeding and hematoma after septal surgery but also proved to be well appreciated by the patient in regards the minimal postoperative discomfort and pain.