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Background: Epistaxis management frequently includes the insertion of a non-absorbable nasal pack, and patients may often be admitted during this treatment. During the recent COVID-19 pandemic, UK guidance to discharge “suitable” patients, with pack in-situ, was published in order to minimise hospital admissions and viral nosocomial transmission. Evidence which defines patient suitability for discharge, however, is lacking. Method: The medical records of 100 patients admitted for idiopathic epistaxis in our trust, managed with non-absorbable packing, were analysed. We sought to determine whether risk factors for re-bleeding through packs, or for haemorrhage-related complications, for which inpatient admission would allow more timely treatment, could be identified. Patient factors and outcomes were correlated using binomial logistic regression. Results: 13 patients re-bled through nasal packing. Statistically significant (1 tailed, P<0.05) predictors of bleeding despite packing were male sex, hypertension diagnosis, and aspirin use, with younger patients being at a modestly increased risk. Warfarin or direct oral anticoagulant (DOAC) use was not associated with increased bleeding risk. Conclusion: This study provides initial evidence of factors that affect the risk of bleeding through packs, and which patients may require inpatient care when packed. We recommend a future multicentre study with larger recruitment numbers to expand upon this pilot study’s results.

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Plastic surgery is a surgical speciality, which typically receives little attention during medical school. Students and newly qualified doctors may therefore wish to develop skills and knowledge within the field of plastic surgery to mitigate a lack of undergraduate exposure. The MY Plastic Surgery Course–Essential Plastic Surgery Skills for Junior Doctors is a course aimed at this cohort; it is a 2-day course based in Yorkshire, organized by plastic surgeons, and covers a broad range of foundational skills in plastic surgery. We present an outline and assessment of the 2022 course, as well as discussing the extent to which it has improved and developed on feedback published in 2021. Overall, the authors found that this course was an excellent introduction to plastic surgery, and we recommend it to medical professionals interested in this surgical speciality.