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November 19, 1982

Nasal Packing After Surgery-Reply

JAMA. 1982;248(19):2452. doi:10.1001/jama.1982.03330190022021

In Reply.—  Although we agree with Dr Fernbach that nasal packing has its disadvantages, the short-term use of packing to effect hemostasis is widely used. The patient described in our report had severe nasal deformity that necessitated septal reconstruction, and we believed that nasal packing was required. We disagree with Herzon's conclusions,1 since we believe that the isolation of bacteria from the nasal cavity is not synonymous with the presence of infection.The use of antibiotic-impregnated gauze as a form of antibiotic prophylactic may serve the purpose of diminishing the fetid odor of nasal packing that has been in situ for 48 hours but will not affect the development of invasive infection. The use of prophylactic antibiotics in any form can be justified only if there is a substantial risk of infection and if the use of such antibiotics is known to be of value.2 We believe that