Nasal packing is standard following sinus or nasal surgeries, such as septoplasty. The primary function of this material is to provide gentle pressure to the surgical site, supporting hemostasis (the control of bleeding). It also helps stabilize internal structures and prevent adhesions during the initial healing phase. Unlike traditional packing, dissolvable packing breaks down and exits the body naturally, reducing the need for manual removal.
Understanding Dissolvable Nasal Packing
Dissolvable packing materials are chosen for their ability to be safely absorbed or naturally flushed out of the nasal cavity. These products are generally composed of bioresorbable substances like gelatin sponges, cellulose-based polymers, or collagen. A common type is carboxymethyl cellulose (CMC), often combined with bovine collagen, which absorbs a large amount of fluid. Using these materials eliminates the need for a second, often painful, procedure to remove non-dissolvable materials like gauze or foam.
The composition serves multiple purposes beyond simple support. The material helps maintain a moist environment that promotes wound healing and acts as a barrier to prevent post-surgical complications. By disintegrating slowly, the material reduces patient discomfort and allows for a smoother post-operative experience.
The Timeline and Mechanism of Exit
Dissolution begins almost immediately after the material is placed inside the nose. The packing absorbs moisture from the nasal environment, primarily blood serum and mucus, causing it to swell and slowly break down. This mechanism of hydration turns the firm material into a softer, more manageable substance.
The gradual breakdown is not instantaneous, and the timeline for expulsion varies based on the material and the patient’s healing rate. Dissolution often begins within the first 24 to 48 hours, but the material can maintain structural integrity for several days. Complete expulsion typically occurs over 3 to 14 days, often facilitated by regular saline nasal irrigation.
Visual Guide to Expelled Packing Material
The appearance of the expelled material often causes patient anxiety because it looks significantly different from the material originally inserted. Once the packing absorbs fluid and begins to dissolve, it transforms into a highly hydrated, slimy, or gelatinous substance. It will no longer resemble a sponge or gel sheet.
This expelled matter is frequently mixed with other elements from the healing nasal cavity. It often contains old, dark blood, crusting, and thick mucus, which is a normal part of the post-operative cleaning process. The color ranges widely, often appearing dark brown or black due to oxidized blood, or sometimes yellow-green or grey, a combination of dissolved packing and nasal discharge.
Patients should expect the discharge to be thick and cohesive, sometimes described as a dark, jelly-like substance. This texture and color are positive signs that the healing process is progressing, with the body naturally clearing the temporary surgical support. The material typically exits gradually, often in small pieces or as a sludge during gentle nasal rinsing, rather than as a single, large mass.
When to Contact Your Physician
While thick, discolored discharge is a normal part of the healing process, patients should remain vigilant for signs of complication. Heavy, bright red bleeding is a primary concern, particularly if it persists despite following prescribed first-aid measures like applying direct pressure. A small amount of bloody discharge is expected, but profuse bleeding requires immediate attention.
Other warning signs include a high fever, defined as above 100.5 degrees Fahrenheit, which could suggest an infection. Persistent, severe pain not managed by prescribed medication should also be reported. Furthermore, any sudden changes in vision, eye pain, or noticeable swelling around the eyes are urgent and require an immediate call to your physician.