An injectable nasal packing helps control bleeding, adhesions, and infection following functional endoscopic sinus surgery (FESS).

The NovaShield Injectable Nasal Packing and Stent is made from chitosan, a polysaccharide derived from the shells of crustaceans, and is available in the form of an injectable, ready-to-use gel that is placed in the sinus or nasal cavities following FESS via an accordion cannula and flexible tip. The gel prevents adhesions by serving as space-occupying packing, promotes stenting of nasal structures (such as turbinates), controls minimal bleeding and oozing, and provides a level of antibacterial effectiveness by forming a barrier at the wound site.

In clinical studies the nasal packing demonstrated fast hemostasis with fewer adhesions, as well as a 95% success rate in the rapid control of nose-bleeding unresponsive to standard nasal packing, even in patients taking antiplatelet or anticoagulant therapy. The gel is also biofragmentable, and thus eliminates the painful packing removal associated with traditional sponge or gauze nasal packing. The NovaShield Injectable Nasal Packing and Stent is a product of Medtronic (Minneapolis, MN, USA), and has been approved by the US Food and Drug Administration (FDA).

“NovaShield is used to separate tissue and prevent adhesions by promoting stenting of nasal structures, such as the turbinates,” said Lisa Sapp, product manager for ENT Biomaterials at Medtronic. “With the benefits of chitosan and its unique design, NovaShield is helpful for both surgeons and patients.”

Chitosan is a linear polysaccharide polymer composed of randomly distributed glucoseamine deacetylated and acetylated units, and is produced by treating shrimp and other crustacean shells with the alkali sodium hydroxide (NaOH). Chitosan also has a number of commercial uses, such as a seed treatment and biopesticide, helping plants to fight off fungal infections. In winemaking it can be used as a fining agent, and it can also be used in self-healing polyurethane paint coating.

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