Reduction of postoperative bruising and swelling

1 April 2017 | James Hsuan | EYE - Oculoplastic, EYE - Orbit

This is a review of 27 patients undergoing periocular surgery who postoperatively applied hydrogel pads impregnated with Arnica montana and Ledum palustre (Ocumend, Cearna inc., Chicago). The pads were used continuously for the first two postoperative days, changing them every six hours, then for three hours a day from day three to day six. An assessment was made of the degree of swelling and bruising by their surgeon between one and eight days after surgery. Healing was graded by comparison with what would normally be expected at that postoperative stage, utilising photographs of patients undergoing similar procedures but not using Arnica / Ledum. The degree of healing was scored as markedly accelerated (seven days ahead of expected), accelerated (one to seven days ahead), or no different. The greatest effect was observed at days three to five, where 86% of patients using the pads were thought to have markedly accelerated healing. The study has a number of serious weaknesses; in particular its retrospective nature and lack of masking of observers undermine its usefulness. Previous randomised controlled trials of Arnica studies have found contrasting results, but a meta-analysis concluded that Arnica was more effective that placebo. There are no previous reports of Arnica and Ledum used together, and this study has shown no adverse effects. The data is not strong enough to prove the effectiveness of these pads, but does suggest further investigation is warranted.