Comparison Of The Clinical Effect Between Medical Collagen Sponge And Colloidal Silver Gelatin Sponge In Prevention Of Postoperative Hemorrhagic Complications Of Mandibular Angle Osteotomy

Purpose:To explore the clinical effects of medical collagen sponge and colloidal silver gelatin sponge in the prevention of postoperative hemorrhagic complications of mandibular angle osteotomy.Postoperative hemorrhagic conditions after mandibular angle osteotomy with the two materials were quantitatively compared by postoperative volume of drainage;this study aimed to identify a more appropriate hemostatic material,reduce postoperative hemorrhage,improve surgical safety,shorten recovery time,and improve degree of satisfaction.Methods:Ninety patients undergoing mandibular angle osteotomy in our hospital,during the period from Mar.2016 to Dec.2017,were randomly divided into three groups according to the date of surgery:collagen sponge group(n=30),colloidal silver gelatin sponge group(n=30),and control group(n=30).All patients were healthy without surgical contraindications.They underwent long-curve bilateral mandibular angle osteotomy combined with mandibular outer cortex osteotomy by the same surgeon to treat prominent mandibular angle.To stop bleeding,the post-osteotomy wound surface was treated with collagen sponge,colloidal silver gelatin sponge,or nothing(untreated),in accordance with the treatment groups.Two negative pressure drainage tubes were placed,and the wound was bound in the mandible.The volume of drainage of each side,bilateral total volume of drainage,extubation time,length of stay,and numbers of cases of hemorrhage,edema,and infection at 1 h,2 h,3 h,6 h,12 h,24 h,and 48 h after the surgery were observed.SPSS 13.0 software was used to analyze and compare the data among the 3 groups.Results:1)In the collagen sponge group,the unilateral and bilateral total volumes of drainage at 1 h,2 h,3 h,6h,and 12 h after the surgery were significantly lower than those in the control group(P<0.05);differences at 24 h and 48 h after the surgery were not statistically significant(P>0.05).2)In the collagen sponge group,the left unilateral total volumes of drainage at 1 h,2h,3 h,and 12 h after the surgery were significantly lower than those in the colloidal silver gelatin sponge group(P<0.05).Differences at 6 h,24 h,and 48 h after the surgery were not statistically significant(P>0.05).In the collagen sponge group,the right unilateral total volumes of drainage at 1 h,2h,3h and 6 h after the surgery were significantly lower than those in the colloidal silver gelatin sponge group(P<0.05).Differences at 12 h,24 h,and 48 h after the surgery were not statistically significant(P>0.05).In the collagen sponge group,the bilateral total volumes of drainage at 1 h,2h,3h,6 h,and 12 h after the surgery were significantly lower than those in the colloidal silver gelatin sponge group(P<0.05).Differences at24 h,and 48 h after the surgery were not statistically significant(P>0.05).3)In the colloidal silver gelatin sponge group,the left unilateral total volumes of drainage at 1 h,2 h,and 3 h after the surgery were significantly lower than those in the control group(P<0.05).Differences at 6 h,12 h,24 h,and 48 h after the surgery were not statistically significant(P>0.05).In the colloidal silver gelatin sponge group,the right unilateral total volumes of drainage at 1 h,2h,3 h,6 h,and 12 h after the surgery were significantly lower than those in the control group(P<0.05).Differences at 24 h,and 48 h after the surgery were not statistically significant(P>0.05).In the colloidal silver gelatin sponge group,the bilateral total volumes of drainage at 1 h,2 h,3 h,and 6 h after the surgery were significantly lower than those in the control group(P<0.05).Differences at 12 h,24 h,and 48 h after the surgery were not statistically significant(P>0.05).4)Extubation time and length of stay in the collagen sponge group were significantly lower than those in the control and colloidal silver gelatin sponge groups(P<0.05);these values in the colloidal silver gelatin sponge group were significantly lower than those in the control group(P<0.05).5)Differences in the incidences of dropsy,infection,hemorrhage,and total complications were not statistically significant among groups(P>0.05).One patient in the collagen sponge group had infection,and one in the colloidal silver gelatin sponge group had hemorrhage.In the control group,one patient had infection and three patients had hemorrhage.All complications were resolved after active treatment without further severe complications.Conclusions:Compared with control(untreated),the use of collagen sponge and colloidal silver gelatin sponge on the wound surface after mandibular angle osteotomy could reduce postoperative volume of drainage,extubation time,and length of stay.Both materials are effective wound hemostatie materials.Compared with eolloidal silver gelatin sponge,the use of collagen sponge on the wound surface during mandibular angle osteotomy could reduce postoperative volume of drainage,extubation time,and length of stay.