Mohammad Moin, Mumtaz Hussain, Nazir Ahmad Aasi.
Dacryocystorhinostomy, Collagen Sponge and Intubation.
Ann King Edward Med Uni Jan ;7(3):156-7.

Postoperative bleeding after dacryocystorhinostomy (DCR) is controlled very well using collagen sponge packing intra operatively. Moreover it keeps the anastomosis patent and prevents any adhesions with the nasal septum during the first week after surgery. We compare the results of cotton gauze packing and collagen sponge used in DCR to control postoperative bleeding. Sixty patients who underwent DCR at the Institute of Ophthalmology from 1999 to 2001 were reviewed. Patients were divided into two groups of 30 patients each. Group A patients underwent external DCR, silicone tube intubation and packing with collagen sponge while Group B patients underwent external DCR silicone intubation and gauze packing. DCR was done in the usual fashion with excision of the posterior lacrimal flap and suturing of only the anterior lacrimal flaps with 6/0 vicryl. All patients in group A had minimal to no bleeding immediately and on the first postoperative day. All patients in group B had minimal to no bleeding immediately after the operation. But on removal of the nasal packing 2 patients had moderate bleeding requiring repacking for another 12 hours, 15 patients had mild bleeding which settled spontaneously and 13 patients had minimal to no bleeding on removal of the packing.

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