Structural Integrity of Absorbable Gelatin Sponges for Middle Ear Packing in Otologic Surgery.
Journal
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
ISSN: 1537-4505
Titre abrégé: Otol Neurotol
Pays: United States
ID NLM: 100961504
Informations de publication
Date de publication:
01 06 2023
01 06 2023
Historique:
medline:
15
5
2023
pubmed:
25
3
2023
entrez:
24
3
2023
Statut:
ppublish
Résumé
This study investigates the physical properties upon immersion of two gelatin sponges commonly used in otologic surgery. Absorbable gelatin sponges are often used in middle ear surgery to achieve hemostasis and, perhaps more importantly, to provide a "scaffolding" to support ossicular chain and/or tympanic membrane reconstructions. Their rate of dissolution may therefore affect the success of tympanic membrane closure. An in vitro study was conducted to quantify the material changes of two absorbable gelatin sponges, a standard-density sponge and one with fewer collagen cross-linkages (low-density sponge). Volume loss (%) in 0.9% saline, 0.3% ciprofloxacin, and/or 0.1% dexamethasone as single-agent otic drops in a combination formulation was measured at 15-minute intervals for the first hour and at days 1, 3, and 5 postimmersion. Secondary end points included compressibility, porosity under microscopy, and infrared spectroscopy analysis. The low-density sponge immersed in any of the three otic solutions showed a statistically significant greater volume loss at all time points when compared with the standard-density sponge (27.2% ± 5.4% vs. 15.4% ± 6.0% at 15 minutes and 44.8% ± 5.1% vs. 34.6% ± 2.9% at 5 days, p < 0.001). Interestingly, both sponges immersed in normal saline had lost almost half of their original volume after 15 minutes when compared with samples immersed in an otic solution (48.3% ± 4.6% vs. 21.3% ± 8.3%, respectively, p < 0.001). The standard-density sponge immersed in an otic solution of ciprofloxacin, dexamethasone, or a combination formulation best maintained its structural integrity. Ancillary in vivo studies are required to assess the hemostatic properties, surgical outcomes, and middle ear synechiae of the above study conditions. Foundational evidence.
Sections du résumé
OBJECTIVE
This study investigates the physical properties upon immersion of two gelatin sponges commonly used in otologic surgery.
BACKGROUND
Absorbable gelatin sponges are often used in middle ear surgery to achieve hemostasis and, perhaps more importantly, to provide a "scaffolding" to support ossicular chain and/or tympanic membrane reconstructions. Their rate of dissolution may therefore affect the success of tympanic membrane closure.
METHODS
An in vitro study was conducted to quantify the material changes of two absorbable gelatin sponges, a standard-density sponge and one with fewer collagen cross-linkages (low-density sponge). Volume loss (%) in 0.9% saline, 0.3% ciprofloxacin, and/or 0.1% dexamethasone as single-agent otic drops in a combination formulation was measured at 15-minute intervals for the first hour and at days 1, 3, and 5 postimmersion. Secondary end points included compressibility, porosity under microscopy, and infrared spectroscopy analysis.
RESULTS
The low-density sponge immersed in any of the three otic solutions showed a statistically significant greater volume loss at all time points when compared with the standard-density sponge (27.2% ± 5.4% vs. 15.4% ± 6.0% at 15 minutes and 44.8% ± 5.1% vs. 34.6% ± 2.9% at 5 days, p < 0.001). Interestingly, both sponges immersed in normal saline had lost almost half of their original volume after 15 minutes when compared with samples immersed in an otic solution (48.3% ± 4.6% vs. 21.3% ± 8.3%, respectively, p < 0.001).
CONCLUSION
The standard-density sponge immersed in an otic solution of ciprofloxacin, dexamethasone, or a combination formulation best maintained its structural integrity. Ancillary in vivo studies are required to assess the hemostatic properties, surgical outcomes, and middle ear synechiae of the above study conditions.
LEVEL OF EVIDENCE
Foundational evidence.
Identifiants
pubmed: 36962059
doi: 10.1097/MAO.0000000000003857
pii: 00129492-202306000-00030
doi:
Substances chimiques
Hemostatics
0
Gelatin
9000-70-8
Dexamethasone
7S5I7G3JQL
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e350-e355Informations de copyright
Copyright © 2023, Otology & Neurotology, Inc.
Déclaration de conflit d'intérêts
The authors acknowledge support from Canada Research Chair Foundation, McGill Engineering Undergraduate Student Masters Award (MEUSMA), Fonds de Recherche du Québec Nature et Technologies (FRQNT), and Quebec Centre for Advanced Materials (CQMF). The authors disclose no conflicts of interest.
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