| Objective:1. To compare effects of chitosan-hyaluronic acid complex powder and Arista hemostatic powder on normal nasal mucosa.2. To investigate the hemostatic effects of chitosan-hyaluronic acid (C.H.) complex powder after ESS and its clinical outcomes.Method:Twenty-four rabbits were divided into 3 parts. Rabbits in Partâ… and Partâ…¡had tests done on one of their maxillary turbinates. Part III had tests done on their bilateral turbinates. Part I had 8 rabbits, including 4 rabbits in an experimental group and 4 in a control group. Turbinate wounds were not inflicted on any of these rabbits. Rabbits in the experimental group had C.H.complex hemostatic powder applied, and rabbits in the control group had their nasal cavities filled with Arista. Both groups were sacrificed on the third day. Maxillary turbinate mucosal samples were from both groups were obtained and observed under light microscopy and scanning electron microscopy. Partâ…¡had 8 rabbits, including 4 rabbits in an experimental group and 4 in a control group. All of the rabbits were inflicted with a unilateral maxillary turbinate wound. The experimental group had C.H. complex hemostatic powder applied to their wounded turbinates. The control group had Merocel applied to their wounds. Rabbits in both groups were sacrificed on the third day after the wounds were made and respective hemostatic agents applied. Maxillary turbinate mucosa samples were obtained and observed under light microscopy and scanning electron microscopy. Part III had 8 rabbits, all inflicted with bilateral maxillary turbinate wounds. Each rabbit had C.H.complex hemostatic powder applied to one of their wounded turbinates, and Arista hemostatic powder was applied to their other wounded turbinate. Then both their nasal cavities were plugged with cotton, which was used to assess the amount of blood loss. Live rabbits had their nasal mucosa observed on days 3,7, and 14 by endoscopy. Four rabbits were sacrificed on day 7, and then 4 more on day 14. Material degradation of the two hemostatic agents was observed on days 3,7, and 14. Nasal mucosa and secretions were obtained for bacterial culture and observed by light microscopy.Results: In Partâ… , the mucosa of both the experimental and control groups were similar to normal mucosa under light microscopy. In Partâ…¡, the mucosa of the experimental group had mild mucosal hyperemia, edema, and inflammatory cell infiltration detected under light microscopy and no abnormal mucosa detected under electron microscopy. The control group had mucosal hyperemia, edema, and inflammatory cell infiltration detected under light microscopy, but there were also obvious signs of bent cilia detected under electron microscopy.In Partâ…¢, there was no significant difference between the hemostatic effects seen in the C.H.complex group and the Arista group (P> 0.05). C.H.complex had a slower material degradation rate than Arista on days 3 and 7 (P<0.05). C.H. complex had a greater inflammatory effect on the mucosa than Arista on days 7 and 14. The C.H. complex groups'bacterial cultures on day 7 showed a greater bacterial load and a greater number of bacterial species than the Arista groups', but there was no significant difference between them on the 14th day.Conclusions:1. Chitosan-hyaluronic acid complex hemostatic powder and Arista do not have a negative effect on normal nasal mucosa.2. Merocel has more obvious negative effects on nasal mucosal membranes than Chitosan-hyaluronic acid complex hemostatic powder.3. Chitosan-hyaluronic acid complex hemostatic powder and Arista have comparable hemostatic effectiveness.4. Chitosan-hyaluronic acid complex hemostatic powder degraded more slowly and caused a greater mucosal inflammatory response than Arista.5. Chitosan-hyaluronic acid complex could become a new clinical nasal absorbable hemostatic packing material.
|
PDF Full Text Request