In New Zealand and the United States, an increasing number of surgeons are using a new postoperative nasal dressing that can be applied to the sinuses after endoscopic sinus surgery.
Chitogel postoperative hydrogel nasal dressing is favoured over older, more traditional methods of packing.
A Wellington based specialist endoscopic sinus surgeon uses Chitogel routinely and finds his patients have a speedier return to normal sinuses.
Maureen is a recent patient at Wellington’s Wakefield Hospital whose experience illustrates why her surgeon now uses Chitogel.
Maureen, a retiree, and grandmother first saw her surgeon in 2020 for revision surgery in June.
It is not unusual for patients with sinus disease to require revision surgery, and Maureen’s initial sinus procedure with another surgeon in 2013 for polyps had failed to resolve her symptoms. Maureen continued to experience a number of typical and severe symptoms of sinus disease: congestion, breathing difficulty, headaches, low energy levels and loss of smell.
At night, she could not sleep because she could not breathe properly and resorted to almost sitting up in bed to sleep. While she thought congestion was the main problem, there were headaches, too.
Before retirement, she says, it was very embarrassing at work:
“I would go to talk to somebody and I wouldn’t be able to get the words out because I was so congested… so I would then avoid talking to people. It made me feel a little bit inadequate.”
Improved wound healing and reduced recovery time
Seven weeks after her revision surgery, Maureen says she feels much better and has loads more energy.
Her surgeon stresses the key feature of her recovery is the speed – the prompt and complete resolution of her symptoms is something he sees often in patients when using Chitogel.
“At about one month into Maureen’s recovery, it was evident how the lining had healed up and how good the sinuses were looking. This all correlates with the quite significant and rapid resolution of all of her symptoms,” he says.
“What we are seeing with using Chitogel is that the mucosa returns to normal very quickly and the critically important sinus ostia have remained wide open.”
For about 10 years, Maureen had lost her sense of smell due to complete obstruction. However, at appointments one and two months postoperatively, it had begun to return. Her surgeon says this is notable in particular because the ability to smell is often the last symptom to resolve.
Improved patient experience
Another important effect of Chitogel is less bleeding:
“It is generally less painful because there’s less bleeding, therefore patients don’t feel as much pressure, and that’s something a lot of patients comment on if they have had previous procedures. It is much more comfortable in that medium postoperative phase (24–48-hour period).”
The presence of a blood clot between mucosal surfaces following sinus surgery greatly increases the risk of adhesion formation, a common reason for surgical failure and the need for revision surgery in the future.
Nurses at Wakefield Hospital have also commented that with Chitogel there is much less bleeding and distress for patients postoperatively. This reduces the need for packing to tamponade the bleeding.
Overall, using Chitogel makes it much more comfortable for the patient. Maureen says her surgery, general anaesthetic, overnight stay and recovery were ‘very, very straightforward’, and she used the recommended pain relief for 48 hours only – even the removal of splints at seven days caused less distress than it did after her first surgery.
Looking forward to a normal life
Seven weeks on following surgery, Maureen has visited her surgeon three times to begin her long-term care and her postoperative routine was ‘straightforward and excellent’.
“This gave me great confidence,” Maureen says. She currently has no congestion and she’s enjoying a full night’s sleep.
“It’s nice just to be able to lie down to sleep, and just live a normal life.”