Influence of chitosan-based dressing on prevention of synechia and wound healing after endoscopic sinus surgery: A meta-analysis

Introduction:

Endoscopic sinus surgery (ESS) has had many complications, e.g., synechia formation. This meta-analysis investigated the effect of a novel chitosan-based dressing on prevention of synechia and wound healing after ESS.

Methods:

We systematically searched various medical literature data bases and included the randomized controlled trials (RCT) regarding the effect of novel chitosan-based dressing on ESS. The study outcomes included synechia, granulations, hemostasis, crusting scores, and infection.

Results:

Six RCTs, which involved 337 patients, were included in the meta-analysis. Compared with control intervention after ESS, chitosan-based gel dressing substantially inhibited synechia (risk ratio [RR] 0.28 [95% confidence interval {CI}, 0.15‐0.54]; p = 0.0001), improved granulations (RR 1.47 [95% CI, 1.07‐2.03]; p = 0.02), and hemostasis (RR 1.47 [95% CI, 1.07‐2.03]; p = 0.02) but demonstrated no effect on crusting scores (standard mean difference −0.41 [95% CI, −1.06 to 0.23]; p = 0.21) and infection (RR 0.88 [95% CI, 0.51‐1.52]; p = 0.64).

Conclusion:

Compared with control intervention, chitosan-based dressing was associated with significantly reduced synechia and with increased granulations and hemostasis but showed no influence on crusting and infection after ESS.