Merocel Tampons (PVA) vs Traditional Ribbon Gauze in the Treatment of Anterior Epistaxis

Résumé

Background: Anterior epistaxis, a common clinical problem, often requires effective nasal packing to manage bleeding. Traditional ribbon gauze and Merocel tampons are widely used packing materials, but their comparative effectiveness and patient outcomes require further evaluation.

Methods and materials: This prospective comparative study was conducted from November 2018 to April 2019 at the Department of ENT & Head Neck Surgery, Shaheed Suhrawardy Medical College Hospital (ShSMCH), Dhaka. Forty patients with anterior epistaxis were randomly assigned to two groups: Group A (ribbon gauze packing) and Group B (Merocel tampons packing). Patients were followed up at 2 days and 7 days post-procedure to assess pain levels, incidence of bleeding, need for repacking, and synechia formation.

Results: Severe pain (8-10) was reported by 85.0% of participants in Group A compared to 15.0% in Group B (p=0.001). Bleeding within the first 48 hours occurred in 5.0% of participants in Group A versus 30.0% in Group B (p=0.037). After pack removal, 15.0% of Group A required repacking due to bleeding compared to 5.0% in Group B. Synechia formation was present in 25.0% of Group A and 10.0% of Group B. Overall, Merocel tampons were associated with lower pain levels and fewer complications, though ribbon gauze was more effective in immediate bleeding control.

Conclusion: Merocel tampons provided better patient comfort and fewer long-term complications compared to traditional ribbon gauze, supporting their use as a preferred treatment for anterior epistaxis. Optimization of management protocols in favour of Merocel tampons will further enhance patient safety and treatment outcomes.