The use of surgicel to stop epistaxis in children secondary to coagulopathies.

Conventional nasal packs, including BIPP (bismuth iodine paraffin paste), merocel or kaltostat are usually used to pack the nasal cavity while the coagulopathies are corrected. However, the coagulation profile can be rather difficult to correct in patients with haematological malignancies e.g. leukaemia. Thrombocytopenia or low platelet count is usually the commonest coagulopathy and can be resistant to platelet transfusion which raises the platelet counts only temporarily . Nasal packs are not without its morbidity. Packs have been reported to absorb large quantities of platelets that are being transfused and occasionally get infected. Furthermore, removal of nasal packs usually leaves raw areas, which again tend to bleed. This starts a vicious cycle.