***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Ninety-five patients undergoing routine nasal surgery were enrolled into a r and omized , prospect i ve trial to investigate the efficacy and morbidity of nasal packing . The patients were r and omized to receive a bismuth iodoform paraffin paste ( BIPP ) pack , a Telfa pack or no pack .  Patients for septal surgery were r and omized between the BIPP and Telfa groups only . They were independently r and omized to receive or not receive , a silastic nasal splint for the first post-operative week . Post-operative pain levels were analysed using a visual analogue scale . Mean pain scores were increased 50 per cent by the use of nasal packs and pack removal , particularly BIPP which , was a most painful event ( p < 0.001 ) . Reactionary haemorrhage occurred in only two patients ( 2.1 per cent ) , both of whom had packs in situ . Vestibulitis was unique to the patients with a silastic splint , who were packed with BIPP , occurring in 21 per cent of them . Similarly septal perforation was unique to this group . There was no significant difference in the incidence of adhesions between the groups which received packs and those who did not . Routine nasal packing , especially with BIPP , would seen difficult to justify in view of the increased pain levels and increased complications which occur without any demonstrable benefit in the majority of patients . Therefore packing should be reserved for cases where there is concern about persistent haemorrhage . In these cases Telfa would be preferable to BIPP Background Periorbital edema and ecchymosis following rhinoplasty is disturbing for both the patients and their surgeons . The study aim was to determine whether nasal packing after lateral osteotomies in rhinoplasty surgery increases the risk of periorbital ecchymosis post-operatively . Methods This was a prospect i ve self-controlled single-blinded study . Seventy four patients who underwent rhinoplasty with bilateral lateral osteotomies by a single surgeon were enrolled in the study .  Nasal cavity packing for one side was done while the other side was left unpacked .  Periorbital ecchymosis was evaluated by the operating surgeon and a separate surgeon who is unaware of the packing side separately on the first , fourth and seventh day post-operatively . A 4- grade scale was utilized to assess the ecchymosis with grade 4 being the most severe . Results Nasal packing was found to significantly increase the severity and duration of periorbital ecchymosis post rhinoplasty . While no difference was observed between the packed and unpacked sides on the first post-operative day , significant difference was noted on the 4th day ( mean score 2.36 and 1.15 for the packed and unpacked sides , respectively ) and on the 7th day after surgery in favor of the unpacked side ( score 1.24 and 0.61 for the packed and unpacked sides , respectively ) . Conclusion We advise against the routine use of nasal packing in rhinoplasty unless necessary as it contributes to worsen the periorbital ecchymosis from lateral osteotomies and thereby increases the patients ’ “ down time ” after surgery BACKGROUND Early postoperative edema and ecchymosis are the most common factors to complicate initial patient perceptions about rhinoplasty . The current study was conducted to determine the effects of longer steri-strip tape on patient malar and cheek in terms of ecchymosis control and reduction . METHODS Through a r and omized controlled clinical trial , 64 patients who underwent rhinoplasty were r and omly enrolled . One side of the patients ’ face was r and omly selected for different experience of dressing while the main intervention was different length of tape and steri-strip dressing . In one group , the right side and in the rest , the left side of face was applied with steri-stip from the nose to lateral malar and cheek . In the opposite side of the face , steri-strip taping was done from the nose to medical malar and cheek . RESULTS The mean area of ecchymosis after rhinoplasty through our trial was 1.55 mm and 2.31 mm , respectively in sides with and without steri-strip which differed significantly . When patients ’ age and sex were taken into account , the distribution of ecchymosis had no significant difference in this regard . CONCLUSION The present study showed significant reduction in the area of post-rhinoplasty ecchymosis in lower lid , malar and cheek soft tissues as well as the obvious increase in satisfaction rate among intervention side of face in comparison to the control side . But longer steri-strip tape failed to control sub conjunctival bleeding or decrease it Background Comparison of the two methods of decongestant and three doses of dexamethasone on reducing edema and ecchymosis  after septorhinoplasty . Methods Seventy-four patients who were c and i date s for rhinoplasty were r and omly divided into three groups . Group A received 8 mg of i.v . dexamethasone preoperatively and again after 24 and 48 hours after surgery , group B received three pseudoephedrine tablets ( 60 mg ) per day for 1 week , and group C received three pseudoephedrine tablets ( 60 mg ) per day for 2 weeks . Finally , their effects on the eye , tip and dorsal edema , and ecchymosis were evaluated . Results Our findings showed that both decongestant and corticosteroid had significant short-term effects on edema and ecchymosis , but only continuation of pseudoephedrine could reduce the evaluated variables after 1 week . Conclusion Pseudoephedrine can be effective for reducing eyelid edema and ecchymosis after rhinoplasty . Also , administration of three doses of dexamethasone in the postoperative care of nasal plastic surgery harmlessly diminished postsurgical edema BACKGROUND Edema persists for months after rhinoplasty . Numerous modalities have been described to counteract postoperative edema . OBJECTIVE To evaluate the effect of postrhinoplasty taping ( PRT ) on nasal edema and nasal draping . DESIGN , SETTING , AND PARTICIPANTS In this r and omized clinical trial , 57 patients undergoing rhinoplasty at a tertiary reference center from August 1 , 2014 , to January 31 , 2015 , were assigned to a control group or to 2- or 4-week PRT groups .  Baseline nasal thickness was measured with ultrasonography at the nasion , rhinion , supratip , and tip , and mean nasal skin thickness ( MNST ) was calculated . Participants in each group were categorized by the baseline MNST measurement from the lowest to greatest MNST ; those in the upper half were categorized as having thick skin ; those in the lower half , thin skin . The control group underwent no PRT after the removal of external packing . Patients in the 2- and 4-week PRT groups received additional taping during the allocated time . Data were collected from August 1 , 2014 , to June 31 , 2015 . Follow-up was completed on June 31 , 2015 , and data were analyzed from July 1 to August 1 , 2015 . MAIN OUTCOMES AND MEASURES Postoperative measurements of MNST were performed at the end of weeks 1 , 3 , and 5 and month 6 . RESULTS Of the 57 total patients ( 33 male and 24 female patients ; mean [ SD ] age , 30.0 [ 11.7 ] years ) , 17 were in the 2-week PRT group ; 20 , the 4-week PRT group ; and 20 , the control group . Compared with the control group , 4-week PRT had a significant effect on the supratip ( P = .001 ) . Comparisons of MNST with the control group revealed significant effects of 2-week ( P = .02 ) and 4-week ( P = .007 ) PRT . The effect on the tip was not significant ( P = .052 ) . Postrhinoplasty taping had no effect in thin-skinned patients . Comparison among thick-skinned patients revealed a significant effect on the MNST ( P = .01 ) and the rhinion ( P = .02 ) but not the tip ( P = .06 ) and supratip ( P = .07 ) . CONCLUSIONS AND RELEVANCE Postrhinoplasty taping helps the skin envelope to compress to the underlying framework and decrease postoperative edema . The procedure can be used particularly in thick-skinned patients , in whom skin draping and nasal refinement is crucial to the surgical outcome . LEVEL OF EVIDENCE 1 . TRIAL REGISTRATION clinical trials.gov Identifier : NCT02626585 Background : Both arnica and corticosteroids have been suggested for reducing the postoperative edema and bruising associated with rhinoplasty . This study compared the efficacy of these products following rhinoplasty . Methods : Forty-eight primary rhinoplasty patients were r and omized into three groups : group P received 10 mg of dexamethasone ( intravenously ) intraoperatively followed by a 6-day oral tapering dose of methyl-prednisone ; group A received arnica three times a day for 4 days ; and group C received neither agent and served as the control . Three blinded panelists rated the extent of ecchymosis , the intensity of the ecchymosis , and the severity of the edema . Results : On postoperative day 2 , there were no significant differences in the ratings of extent and intensity of ecchymosis among the groups . There was a significant difference for the edema rating ( p < 0.0001 ) , with group C demonstrating more swelling compared with groups A and P. In addition , on postoperative day 8 , group P demonstrated a significantly larger extent of ecchymosis ( p < 0.05 ) and higher intensity of ecchymosis ( p < 0.01 ) compared with groups A and C. There were no differences in the magnitude of edema by postoperative day 8 among the three groups . When the differences between day 2 and day 8 ratings were considered , groups A and C exhibited significantly more resolution of ecchymosis by day 8 compared with group P ( p < 0.05 ) . Conclusions : This study suggests that both arnica and corticosteroids may be effective in reducing edema during the early postoperative period . Arnica does not appear to provide any benefit with regard to extent and intensity of ecchymosis . The delay in resolution of ecchymosis for patients receiving corticosteroids may outweigh the benefit of reducing edema during the early postoperative period Objective . The basic aim of this study was to minimize intraoperative bleeding , postoperative eyelid edema , and periorbital ecchymosis and to reduce morbidity with a combination of cold saline-soaked gauze compression and intraoperative single-dose corticosteroids . Study Design . The study was design ed as a prospect i ve , double-blind , r and omized controlled study . Three hundred patients who underwent septorhinoplasty were included . Setting . A tertiary referral hospital in Turkey . Subjects and Methods . Three hundred patients undergoing septorhinoplasty were divided into 2 groups . A single dose of 10 mg dexamethasone was intravenously administered in all cases at the beginning of the operation . In the study group , the nasal dorsum was continuously compressed with cold saline-soaked gauze during the operation . In the control group , the nasal dorsum was compressed with dry gauze continuously during surgery . The operation time and amount of bleeding were recorded during surgery . Degree of eyelid edema and periorbital soft tissue ecchymosis was recorded at 24 hours and on postoperative days 2 , 3 , 5 , and 7 by 2 investigators . Results . The operation time was significantly shorter in the study group than in the control group . Eyelid edema and periorbital ecchymosis were significantly decreased in the study group at the following postoperative days 1 , 3 , 5 , and 7 ( P < .05 ) . Conclusion . Bleeding , edema , and ecchymosis are the main morbidities of rhinoplasty . It is highly probable that cold compression and intraoperative corticosteroids have synergistic effects on these morbidities , especially by the intraoperative control of bleeding Background Studies of homeopathic therapies to decrease postrhinoplasty ecchymosis have previously used subjective measurements , limiting their clinical significance . Recently , Arnica montana was shown to decrease postoperative ecchymosis after rhytidectomy , using an objective measuring tool . We believe that oral A. montana , given perioperatively , can be objective ly shown to reduce extent and intensity of postoperative ecchymosis in rhinoplasty surgery . Methods Subjects scheduled for rhinoplasty surgery with nasal bone osteotomies by a single surgeon were prospect ively r and omized to receive either oral perioperative A. montana ( Alpine Pharmaceuticals , San Rafael , Calif ) or placebo in a double-blinded fashion . Ecchymosis was measured in digital “ three-quarter”–view photographs at 3 postoperative time points . Each bruise was outlined with Adobe Photoshop ( Adobe Systems Incorporated , San Jose , Calif ) , and the extent was scaled to a st and ardized reference card . Cyan , magenta , yellow , black , and luminosity were analyzed in the bruised and control areas to calculate change in intensity . P value of < 0.1 was set as a meaningful difference with statistical significance . Results Compared with 13 subjects receiving placebo  , 9 taking A. montana had 16.2 % , 32.9 % , and 20.4 % less extent on postoperative days 2/3 , 7 , and 9/10 , a statistically significant difference on day 7 ( P = 0.0 
    Output:
    
Eyelid edema and ecchymosis during the first 7 days postoperatively were statistically decreased in the arnica administration groups versus the control group .
Eyelid edema and ecchymosis during the first 24 h postoperatively were statistically decreased in the cold compression group versus the control group .
The ratio of patient satisfaction was statistically higher in the tapping application group than in the control group .
However , the analysis indicated that surgeons had a significant tendency to decrease intranasal packing .
The administration of arnica , cold compression , and tape could reduce eyelid edema and ecchymosis .
Intranasal packing was associated with more adverse effects in terms of postoperative ecchymosis compared to non-packing .