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      The Effect of Hirodoid Cream on Ecchymosis and Edema around Eyes after Rhinoplasty

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          Abstract

          BACKGROUND

          Several methods have been used to decrease the periorbital edema and ecchymosis after rhinoplasty. In this study, we evaluated the efficacy of hirudoid and dexamethasone in reduction of the periorbital edema and ecchymosis.

          METHODS

          Sixty patients who underwent primary rhinoplasty were randomly divided into 3 groups. Group H received hirudoid cream, 3 times per day for 5 days from postoperative-day (POD). Group D received 10 mg of dexamethasone IV, immediately before surgery; and group C (control) received neither dexamethasone nor hirudoid. Two surgeons who were unaware of administered medications rated the severity of edema and intensity of ecchymosis, on 2 nd, 5 th, and 7 th POD.

          RESULTS

          On 2 nd POD, the edema in group D was significantly lower than groups H and C; but there was no significant difference in severity and intensity of ecchymosis between 3 groups. On 7 th POD, the intensity of ecchymosis was significantly lower in group H in comparison to group C. When the difference between 2 nd and 7 th POD was evaluated, the resolution of severity of edema and intensity of ecchymosis was significantly better in group H ( p<0.001).

          CONCLUSION

          Hirudoid was shown to be effective in reducing edema and ecchymosis after rhinoplasty. The use of dexamethasone was effective in prevention of periorbital edema at early postoperative days, but it was not effective on resolution of ecchymosis.

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          Most cited references12

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          A Randomized, Controlled Comparison between Arnica and Steroids in the Management of Postrhinoplasty Ecchymosis and Edema

          Both arnica and corticosteroids have been suggested for reducing the postoperative edema and bruising associated with rhinoplasty. This study compared the efficacy of these products following rhinoplasty.
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            Effects of single-dose steroid usage on edema, ecchymosis, and intraoperative bleeding in rhinoplasty.

            To examine the effects of single-dose dexamethasone use on edema, ecchymosis, and intraoperative bleeding in rhinoplasty, a double-blind, randomized trial with placebo control was planned. A total of 55 consecutive patients were included in the study. The dexamethasone (10 mg) was given intravenously just before surgery (preoperative group, n=18) or at the end of surgery (postoperative group, n=20). In the placebo group, 17 patients received saline preoperatively or postoperatively. Intraoperative blood loss was recorded for each patient. Postoperative scoring of eyelid swelling and ecchymosis was begun after approximately 24 hours and lasted into postoperative day 9. Only for the first 2 days was the difference between steroid groups (preoperative and postoperative) and the placebo group statistically significant for a decrease in eyelid edema (p < 0.05). A statistically significant difference in upper eyelid ecchymosis for both preoperative and postoperative steroid groups versus the placebo group also existed in the first 2 days (p < 0.05). Preoperative or postoperative steroid administration had no influence on the ecchymosis of the lower eyelid. When the results of the preoperative and postoperative steroid groups were compared, no significant difference was detected between the two groups in either edema or ecchymosis. To determine whether steroid use shortened the recovery period, the days on which edema and ecchymosis reached a minimum level were compared among the groups; no statistically significant difference was found among them. Using single-dose dexamethasone preoperatively did not alter intraoperative blood loss. Use of single-dose dexamethasone (either preoperatively or postoperatively) in rhinoplasty has a significant effect in decreasing upper and lower eyelid edema and upper eyelid ecchymosis for the first 2 days when compared with a placebo group. However, the effect of dexamethasone was lost after the first 2 days, and its use did not shorten the recovery period.
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              The Effectiveness of Steroids for Edema, Ecchymosis, and Intraoperative Bleeding in Rhinoplasty

              The aim of this study was to investigate the dose-related effectiveness of steroids on periorbital edema, ecchymosis, and intraoperative bleeding in patients who underwent open rhinoplasty with osteotomy.
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                Author and article information

                Journal
                World J Plast Surg
                World J Plast Surg
                WJPS
                World Journal of Plastic Surgery
                Iranian Society for Plastic Surgeons (Tehran, Iran )
                2228-7914
                2252-0724
                May 2020
                : 9
                : 2
                : 128-134
                Affiliations
                [1 ]Department of Plastic and Reconstructive Surgery, Shahid Modares Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
                [2 ]Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran;
                [3 ]Department of Surgery, Lorestan University of Medical Sciences, Khorramabad, Iran
                Author notes
                [* ]Corresponding Author: Hormoz Mahmmoudvand, MD; Department of Surgery, Lorestan University of Medical Sciences, Khorramabad, Iran. Email: dr.mahmoudvand@gmail.com
                Article
                10.29252/wjps.9.2.128
                7482541
                32934922
                f647899d-73fb-424b-b862-048226d8c438

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 August 2019
                : 20 March 2020
                : 30 March 2020
                Categories
                Original Article

                hirodoid,ecchymosis,edema,periorbital,eye,rhinoplasty
                hirodoid, ecchymosis, edema, periorbital, eye, rhinoplasty

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