THE EFFECT OF PLATELET RICH PLASMA ON POST OPERATIVE WOUND HEALING FOLLOWING ENDOSCOPIC SINUS SURGERY-A PROSPECTIVE STUDY

Abstract

Background: Chronic rhinosinusitis (CRS), is the persistent inflammation of the mucosal lining of the nose and paranasal sinuses, affecting approximately 11% of individuals. Functional endoscopic sinus surgery (FESS) is the primary treatment for CRS unresponsive to medical management. Despite its efficacy, FESS can result in complications such as bleeding, crusting, adhesions, and infections, which can impair wound healing and mucociliary clearance, potentially leading to disease recurrence. Effective postoperative care is crucial to improve surgical outcomes. Platelet rich plasma, is an autologous compound rich in platelets and growth factors. It provides an environment conducive to wound healing and has anti-inflammatory, haemostatic, and antimicrobial properties. This study evaluates the effectiveness of platelet rich plasma in enhancing postoperative recovery following FESS. Objectives:  To perform anterior nasal packing after topical application of platelet rich plasma in one nasal cavity and without platelet rich plasma in the other nasal cavity following endoscopic sinus surgery and document the outcome in each nasal cavity in terms of wound healing and post operative complications like bleeding, crusting, adhesion, infection, and pain.  To determine the effect of platelet rich plasma in reducing post operative bleeding, crusting, adhesion, infection, and pain after endoscopic sinus surgery for chronic rhinosinusitis by comparing the outcome between the two nasal cavities in the above mentioned patients. xvii Study type: Prospective comparative study Methods: 42 patients diagnosed with bilateral CRSwNP and CRSsNP who underwent FESS at RL Jalappa hospital were included in the study. Following FESS, platelet rich plasma was instilled in one nasal cavity and normal saline in the other nasal cavity and nasal packing was done. Patients were assessed for the presence of bleeding, crusting, infection, adhesion and postoperative pain and grading was done at 1week, 2weeks and 3months post operatively. Results: Our study has shown that in the 1st postoperative week, platelet rich plasma shows significant reduction in bleeding, adhesion, crusting and postoperative pain. Postoperative infection rates were comparable between the PRP side and saline side in the first week. In the second week, there was significant decrease noted on the side of PRP for adhesion and infection. At the 3rd month there was significant decrease in crusting alone on the side of PRP. Thereby showing that PRP has a positive effect on wound healing in the initial post operative period and its long-term effect must be looked in detail in further studies. Conclusion: Our study demonstrated that platelet--rich plasma (PRP) significantly improves postoperative outcomes in endoscopic sinus surgery for chronic rhinosinusitis. Platelet rich plasma has found to effective in decreasing bleeding, crusting, postoperative pain, and adhesion. These benefits can be attributed to PRP's biostimulatory properties, which facilitate wound healing and reduce inflammation. It is a minimally invasive and inexpensive. Therefore, it can be advocated as an effective treatment following endoscopic sinus surgery, potentially leading to better recovery, and improved quality of life.