Platelet Gel for Endoscopic Sinus Surgery

Pomerantz, Jonathan; Dutton, Jay M.

doi:10.1177/000348940511400908

Cited by 44 publications

(44 citation statements)

References 10 publications

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“…In their study, none of the patients showed postoperative bleeding that required packing. 17 To date, no conclusive evidence has been obtained for an optimal packing material that is superior to all the others with respect to prevention of postoperative bleeding.…”

Section: Discussionmentioning

confidence: 99%

The effects of Vaseline gauze strip, Merocel, and Nasopore on the formation of synechiae and excessive granulation tissue in the middle meatus and the incidence of major postoperative bleeding after endoscopic sinus surgery☆

Wang

Chen

et al. 2011

Journal of the Chinese Medical Association

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Among patients who had undergone ESS for rhinosinusitis with or without polyps, the incidence of synechiae and excessive granulation tissue in the middle meatus and major postoperative bleeding in the patients who received Vaseline gauze packing was equivalent to the incidence of these complications in the patients who received Merocel. Nasopore was not superior to the other two nonabsorbable packing materials.

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Section: Discussionmentioning

confidence: 99%

The effects of Vaseline gauze strip, Merocel, and Nasopore on the formation of synechiae and excessive granulation tissue in the middle meatus and the incidence of major postoperative bleeding after endoscopic sinus surgery☆

Wang

Chen

et al. 2011

Journal of the Chinese Medical Association

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“…The authors reported no postoperative bleeding in either arm of the study. 11 Similarly, in a study by Baumann et al (level 2 evidence), the incidence of postoperative bleeds was calculated and they did not find a difference between FloSeal (1/50) and Merocel (2/50). 7 Vaiman et al took a different perspective on postoperative bleeds and calculated into the equation the bleeding caused by pulling Merocel packs.…”

Section: Middle Meatal Packing For Hemostasismentioning

confidence: 96%

A Scientific Review of Middle Meatal Packing/stents

Weitzel

Wormald

2008

American Journal of Rhinology

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The most effective hemostatic agent currently available is FloSeal; however, this product causes an increase in adhesion formation. For the purpose of preventing adhesions, resorbable packs appear to have no benefit over either nonresorbables or no packing. If the middle turbinate is unstable at the conclusion of surgery, suturing it to the septum may reduce adhesions. Although mitomycin C, hyaluronic acid, and retinoic acid all have shown potential in these roles, to date, none have shown to be useful in the post-ESS chronic sinusitis human patient.

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“…These authors suggest that the use of PLG contributed to an enhanced hemostatic response, accelerated tissue healing, and improved collagen synthesis, thus preventing anastomotic leaks and thereby improving outcome. Recently, Pomerantz and Dutton [33] applied PLG during endoscopic sinus surgery to improve their packing technique. Their quality-of-life scores showed an improvement in terms of postoperative epistaxis, synechia formation, and exuberant granulation tissue in PLG-treated patients.…”

Section: Soft Tissue Healing and Endoscopic Applicationsmentioning

confidence: 99%

The use of autologous platelet–leukocyte gels to enhance the healing process in surgery, a review

et al. 2007

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Background: The therapeutic use of autologously prepared, platelet-leukocyte-enriched gel (PLG) is a relatively new technology for the stimulation and acceleration of soft tissue and bone healing. The effectiveness of this procedure lies in the delivery of a wide range of platelet growth factors mimicking the physiologic wound healing and reparative tissue processes. Despite an increase in PLG applications, the structures and kinetics of this autogenously derived biologic material have not been observed. Methods: A review of the most recent literature was performed to evaluate the use of PLG in various surgical disciplines. Results: The review showed that the application of PLG has been extended to various surgical disciplines including orthopedics, cardiac surgery, plastic and maxillofacial surgery, and recently also endoscopic surgery. Conclusion: This review demonstrates the usefulness of PLG in a wide range of clinical applications for improvement of healing after surgical procedures.Key words: Growth factors -Leukocytes -Platelet gel -Wound healing Soft tissue wound healing and bone growth involve physiologic cascades in which cellular and hormonal factors play pivotal roles [1,2]. Some of these cascade components can be isolated from autologously drawn whole blood. Point-of-care devices can intraoperatively fractionate the autologous blood into platelet-poor plasma, platelet-leukocyte-rich plasma (P-LRP), and red blood cells [3,4]. The P-LRP fraction, a mixture of concentrated platelets and leukocytes, can be activated by (autologous) thrombin to create a viscous solution known as platelet-leukocyte gel (PLG). This platelet coagulum can be exogenously applied to soft wound tissues, bone, or synthetic bone as a spray or as a solid, clotted, gelatinous mass. The rationale for applying platelet gel is based on the delivery of platelet growth factors to tissues and on the fact that platelet a-granules, found inside the platelets, contain a variety of growth factors [5]. Platelet gel growth factors are peptides that promote cell proliferation, differentiation, chemotaxis, and the migration of various cells involved in both wound healing and bone growth [6,7].Recently, numerous P-LRP devices have become available for therapeutic use to stimulate and accelerate soft tissue and bone healing and to control postoperative wound bleeding. The rationale for applying PLG lies in the mimicking and accelerating of physiologic wound healing and reparative tissue processes.This article provides information on the results of electron microscopic imaging used to evaluate the content of PLG. Furthermore, because the use of PLG is a relatively new per-and/or perioperative biotechnological application, new and additional indications for the use of PLG are defined. New PLG applications are reviewed for different applications including cardiac surgery, general surgery, orthopedics and traumatology, cosmetic surgery, maxillofacial surgery, sports medicine, and endoscopic surgical procedures. Defining platelet-leukocyte-rich...

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Platelet Gel for Endoscopic Sinus Surgery

Abstract: Platelet gel used as a packing material after endoscopic sinus surgery offers efficient hemostatic properties, as well as growth factors that can advance the healing process. The quality of life of the patient may be improved by the use of platelet gel packing.

Cited by 44 publications

References 10 publications

The effects of Vaseline gauze strip, Merocel, and Nasopore on the formation of synechiae and excessive granulation tissue in the middle meatus and the incidence of major postoperative bleeding after endoscopic sinus surgery☆

The effects of Vaseline gauze strip, Merocel, and Nasopore on the formation of synechiae and excessive granulation tissue in the middle meatus and the incidence of major postoperative bleeding after endoscopic sinus surgery☆

A Scientific Review of Middle Meatal Packing/stents

The use of autologous platelet–leukocyte gels to enhance the healing process in surgery, a review

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