FloSeal use in endoscopic sinus surgery: Effect on postoperative bleeding and synechiae formation

Purpose: The objective of this study is to evaluate the effect of the hemostatic agent, FloSeal (FS), on bleeding and healing after functional endoscopic sinus surgery. Methods: We performed randomized, double-blinded, controlled study at a tertiary care center. Patient nasal sides were randomized to FS or control. After completion of sinus surgery, FS was placed in the appropriate nasal cavities followed by saline-soaked neuropatties in both nasal cavities. Control sides received saline-soaked neuropatties alone, without FS. Results: Forty-five patients were enrolled. Mean time to cessation of bleeding in recovery was 16.4 and 30.8 minutes for the FS- and control-treated sides, respectively (P = .028). Patients maintained diaries for 7 days postoperatively and reported similar durations of bleeding at home, but indicated less discomfort on the FS-treated side. Postoperative endoscopic examinations revealed significantly less crusting in FS-treated nasal cavities at 1 week, but significant difference at 1 and 3 months. There were no differences in postoperative scarring or middle turbinate lateralization. Conclusions: Use of FS after functional endoscopic sinus surgery resulted in less bleeding, immediately postoperatively, and less discomfort, and did not increase the incidence of crusting or scarring compared with control.