What is the role of commercial products in anterior nasal packing for epistaxis?

Updated: May 09, 2018
  • Author: Eric Goralnick, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

Anterior packing with prefabricated nasal tampons begins with applying anesthetic to the nasal mucosa with cotton balls or via inhalation. Apply surgical lubricant to the tampon, and gently insert it to the maximum achievable depth. Advance the tampon almost horizontally, along the floor of the nasal cavity.

The Merocel nasal tampon is made of polyvinyl alcohol, which is a compressed foam polymer that is inserted into the nose and expanded by application of water. The nasal tampon swells and fills the nasal cavity and applies pressure over the bleeding point. The Merocel tampon is believed to aggregate clotting factors to reach a critical level, thereby promoting coagulation. The Merocel success rate is 85% (equal to that of traditional ribbon gauze).

The Rapid Rhino anterior balloon tampon is made of carboxymethylcellulose, a hydrocolloid material. It acts as a platelet aggregator and also forms a lubricant upon contact with water. Unlike Merocel, the Rapid Rhino balloon has a cuff that is inflated by air. The hydrocolloid or Gel-Knit reportedly preserves the newly-formed clot during tampon removal.


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