Efficacy of the Combination of Intraoperative Cold Saline‐Soaked Gauze Compression and Corticosteroids on Rhinoplasty Morbidity

Taşkın, Ümit; Yiğit, Özgür; Bilici, Suat; Kuvat, Samet Vasfi; Sisman, Ayse Sezim; Çelebi, Şaban

doi:10.1177/0194599811400377

Cited by 36 publications

(51 citation statements)

References 25 publications

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“…Operative and postoperative use of iced salinesoaked gauze applied to the external nose 101 2. Postoperative use of low-pressure, high-volume nasal irrigation with normal saline and fluticasone by the patient after discharge 59 3.…”

mentioning

confidence: 99%

Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty

Ishii

Tollefson

Basura

et al. 2017

Otolaryngol.--head neck surg.

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Objective. Rhinoplasty, a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway, ranks among the most commonly performed cosmetic procedures in the United States, with >200,000 procedures reported in 2014. While it is difficult to calculate the exact economic burden incurred by rhinoplasty patients following surgery with or without complications, the average rhinoplasty procedure typically exceeds $4000. The costs incurred due to complications, infections, or revision surgery may include the cost of long-term antibiotics, hospitalization, or lost revenue from hours/days of missed work.The resultant psychological impact of rhinoplasty can also be significant. Furthermore, the health care burden from psychological pressures of nasal deformities/aesthetic shortcomings, surgical infections, surgical pain, side effects from antibiotics, and nasal packing materials must also be considered for these patients. Prior to this guideline, limited literature existed on standard care considerations for pre-and postsurgical management and for standard surgical practice to ensure optimal outcomes for patients undergoing rhinoplasty. The impetus for this guideline is to utilize current evidence-based medicine practices and data to build unanimity regarding the peri-and postoperative strategies to maximize patient safety and to optimize surgical results for patients.Purpose. The primary purpose of this guideline is to provide evidence-based recommendations for clinicians who either perform rhinoplasty or are involved in the care of a rhinoplasty candidate, as well as to optimize patient care, promote effective diagnosis and therapy, and reduce harmful or unnecessary variations in care. The target audience is any clinician or individual, in any setting, involved in the management of these patients. The target patient population is all patients aged ≥15 years. The guideline is intended to focus on knowledge gaps, practice variations, and clinical concerns associated with this surgical procedure; it is not intended to be a comprehensive reference for improving nasal form and function after rhinoplasty. Recommendations in this guideline concerning education and counseling to the patient are also intended to include the caregiver if the patient is <18 years of age.Action Statements. The Guideline Development Group made the following recommendations: (1) Clinicians should ask all patients seeking rhinoplasty about their motivations for surgery and their expectations for outcomes, should provide feedback on whether those expectations are a realistic goal of surgery, and should document this discussion in the medical record. (2) Clinicians should assess rhinoplasty candidates for comorbid conditions that could modify or contraindicate surgery, including obstructive sleep apnea, body dysmorphic disorder, bleeding disorders, or chronic use of topical vasoconstrictive intranasal drugs. (3) The surgeon, or the surgeon's designee, should evaluate the rhinoplasty candidate for...

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mentioning

confidence: 99%

Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty

Ishii

Tollefson

Basura

et al. 2017

Otolaryngol.--head neck surg.

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“…Osteotomies are basically a form of (controlled) trauma with a considerable disruption of the abundant blood vessels in this facial region and, therefore, are associated with undesirable effects (11,14). Edema and ecchymosis are main concerns for patients after rhinoplasty (4).…”

Section: Discussionmentioning

confidence: 99%

“…Previous randomized controlled trials have implemented prednisone (4,17), methylprednisolone (2,9-11), betamethasone (2) and dexamethasone (2)(3)(4)(5)14,16), among others, and have suggested better results if high and repeated doses are given versus placebo, in most cases (1)(2)(3)(4)(5)9,10). Most reports present isolated findings of one type of steroid compared with placebo; two studies, however, have reported conflicting results.…”

Section: Discussionmentioning

confidence: 99%

“…Although no complications have been reported in different series (1,2,4,5,7,(9)(10)(11)(13)(14)(15), it is our opinion that we should consider the side effects that high doses of methylprednisolone could have if used frequently in our practice.…”

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confidence: 85%

“…Other types of measures, either alone or in conjunction with steroids, have been used in an attempt to reduce these sequelae, such as arnica (15), controlled hypotension during surgery (16) and cold saline gauze compression throughout surgery (14), among others.…”

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confidence: 99%

See 2 more Smart Citations

Testing the effects of long-acting steroids in edema and ecchymosis after closed rhinoplasty

Gutiérrez¹,

Wuesthoff²

2014

CAN J PLAST SURG

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The efficacy of steroids for edema and ecchymosis after Rhinoplasty: A meta‐analysis

et al. 2014

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Efficacy of the Combination of Intraoperative Cold Saline‐Soaked Gauze Compression and Corticosteroids on Rhinoplasty Morbidity

Abstract: Bleeding, edema, and ecchymosis are the main morbidities of rhinoplasty. It is highly probable that cold compression and intraoperative corticosteroids have synergistic effects on these morbidities, especially by the intraoperative control of bleeding.

Cited by 36 publications

References 25 publications

Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty

Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty

Testing the effects of long-acting steroids in edema and ecchymosis after closed rhinoplasty

The efficacy of steroids for edema and ecchymosis after Rhinoplasty: A meta‐analysis

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