Supplementary Material for: Comparison of Absorbable Packing versus No Packing in Wound Healing after Endoscopic Sinus Surgery: A Systematic Review and Pooled Analysis

<b><i>Introduction:</i></b> Nasal packing after endoscopic sinus surgery (ESS) is controversial. The aim of this systematic review was to compare absorbable packing versus no packing in wound healing after ESS for the treatment of chronic rhinosinusitis. <b><i>Data Source:</i></b> English electronic databases, including Cochrane Library, EMBASE, MEDLINE, and PubMed, were searched, and only randomized controlled trials were included. <b><i>Methods:</i></b> The outcome measures were the presence of synechiae/adhesion formation, mucosal edema, crusting, granulation formation, and infection. The McNemar’s test was used for pooled analysis. <b><i>Results:</i></b> Four studies with 148 participants were included. The pooled analysis showed that absorbable packing may offer benefit in reducing adhesion at 6–8 weeks (odds ratio [OR]: 0.3864; 95% confidence interval [CI]: 0.2136–0.7235) and 12 weeks (OR: 0.2396, 95% CI: 0.08267–0.7709) postoperatively compared with no packing. There was no significant difference between the packed and the unpacked side at 2, 6–8, and 12 weeks after ESS in terms of presence of crusting, edema, and granulation formation. <b><i>Conclusion:</i></b> There is insufficient evidence to suggest that absorbable packing after ESS does not increase mucosal edema, granulation formation, and infection. However, the absorbable packing may be more effective than no packing for the prevention of mucosal adhesion after ESS. The use of absorbable nasal packing after ESS is recommended when used to reduce postoperative mucosal adhesion. More research in this area is clearly needed.

**引言：** 鼻内镜鼻窦手术（Endoscopic Sinus Surgery, ESS）术后鼻腔填塞的临床价值尚存争议。本系统综述旨在对比慢性鼻-鼻窦炎患者接受ESS术后，使用可吸收鼻腔填塞与不使用填塞对伤口愈合的影响。
**数据来源：** 检索包括Cochrane图书馆、EMBASE、MEDLINE及PubMed在内的英文电子数据库，仅纳入随机对照试验。
**方法：** 本研究的结局指标包括粘连形成、黏膜水肿、结痂、肉芽组织形成及感染情况。采用麦克内马尔检验（McNemar’s test）进行合并分析。
**结果：** 共纳入4项研究，涉及148名受试者。合并分析结果显示，相较于不填塞组，术后6~8周（比值比[OR]=0.3864，95%置信区间[CI]：0.2136~0.7235）及术后12周（OR=0.2396，95%CI：0.08267~0.7709）使用可吸收填塞可降低粘连发生率。术后2周、6~8周及12周时，填塞侧与未填塞侧在结痂、水肿及肉芽组织形成方面无显著差异。
**结论：** 现有证据不足以证实，ESS术后应用可吸收鼻腔填塞不会增加黏膜水肿、肉芽组织形成及感染的发生风险。不过，相较于不填塞，可吸收填塞在预防ESS术后黏膜粘连方面可能更具优势。因此，当临床需减少术后黏膜粘连时，推荐在ESS术后使用可吸收鼻腔填塞。该领域仍需开展更多相关研究。