Aesthetic Plastic Surgery

, Volume 43, Issue 6, pp 1603–1606 | Cite as

The Hemostatic Effect of Desmopressin on Bleeding as a Nasal Spray in Open Septorhinoplasty

  • Shahriar Haddady-Abianeh
  • Ahmad Ali Rajabpour
  • Mehdi Sanatkarfar
  • Mohammad Reza Farahvash
  • Ghasemali Khorasani
  • Hojjat MolaeiEmail author
Original Article Rhinoplasty



Rhinoplasty is associated with intraoperative bleeding which affects the quality of the operation and may increase the time of surgery. The aim of this study was to assess the role of nasal spray of desmopressin on reduction in intraoperative bleeding during elective open rhinoplasty.


Conducting an interventional study in our hospital, all patient data including demographic information, medical history and laboratory tests before surgery were collected. Patients who were randomly divided into two study groups, received nasal desmopressin spray or placebo spray, 60 min before starting open septorhinoplasty. The measured variables included: bleeding volume, the operative field quality in regard to bleeding (Boezaart score), the surgeons' satisfaction in regard to bleeding during surgery (Likert scale), postoperative bruising, postoperative bleeding and menstruation.


Thirty cases were studied; 13 (46.3%) people received placebo and 17 (56.7%) received desmopressin. The Boezaart score, satisfaction scores, bleeding volume, upper eyelid ecchymosis in the group receiving desmopressin were significantly better than the control group. Postoperative bleeding was also less in the desmopressin group, but not significant as other variables. In women of each group, menstruation had no effect on the amount of bleeding, surgical field quality and surgeon satisfaction compared with non-menstruation women.


Nasal desmopressin use is an effective method for reducing intraoperative and postoperative bleeding and diminished postoperative ecchymosis which improves surgeons’ satisfaction. So using the nasal form of desmopressin could be considered as method of controlling bleeding and ecchymosis in open rhinoplasty.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors



The authors thank Muhammed Hussein Mousavinasab for editing this text.



Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interests.

Ethical Approval

This article was based on fellowship thesis accepted by ethic committee with number: 9311256006 and all human rights were respected accordingly.

Informed Consent

All patients signed informed consents (in Persian forms) while enrolling the study.


  1. 1.
    Baric D, Biocina B, Unic D et al (2007) Topical use of antifibrinolytic agents reduces postoperative bleeding: a double-blind, prospective, randomized study. Eur J Cardithorac Surg 31(3):366–371CrossRefGoogle Scholar
  2. 2.
    Guyuron B, Vaughan C, Schlecter B (1996) The role of DDAVP (desmopressin) in orthognathic surgery. Ann Plast Surg 37:516–519CrossRefGoogle Scholar
  3. 3.
    DiMichele DM, Hathaway WE (1990) Use of DDAVP in inherited and acquired platelet dysfunction. Am J Hematol 33:39–45CrossRefGoogle Scholar
  4. 4.
    Athanasiadis T, Beule A, Embate J, Steinmeier E, Field J, Wormald PJ (2008) Standardized video-endoscopy and surgical field grading scale for endoscopic sinus surgery: a multi-centre study. Laryngoscope 118(2):314–319CrossRefGoogle Scholar
  5. 5.
    Farahvash MR, Khorasani G, Mahdiani Y, Taheri AR (2016) The effect of Steri-Strip dressing on patients’ satisfaction and reduction of ecchymosis in lower eyelid, malar and cheek following rhinoplasty. World J Plast Surg 5(1):2–8Google Scholar
  6. 6.
    Kargi E, Hoşnuter M, Babucçu O, Altunkaya H, Altinyazar C (2003) Effect of steroids on edema, ecchymosis, and intraoperative bleeding in rhinoplasty. Ann Plast Surg 51(6):570–574CrossRefGoogle Scholar
  7. 7.
    Coroneos CJ, Voineskos SH, Cook DJ, Farrokyar F, Thoma A (2016) Perioperative corticosteroids reduce short-term edema and ecchymosis in rhinoplasty: a meta-analysis. Aesthet Surg J 36(2):136–146CrossRefGoogle Scholar
  8. 8.
    Chaiet SR, Marcus BC (2016) Perioperative Arnica montana for reduction of ecchymosis in rhinoplasty surgery. Ann Plast Surg 76(5):477–482CrossRefGoogle Scholar
  9. 9.
    Ho D, Jagdeo J, Waldorf HA (2016) Is There a role for arnica and bromelain in prevention of post-procedure ecchymosis or edema? A systematic review of the literature. Dermatol Surg 42(4):445–463CrossRefGoogle Scholar
  10. 10.
    Faber C, Larson K, Amirlak B, Guyuron B (2011) Use of desmopressin for unremitting epistaxis following septorhinoplasty and turbinectomy. Plast Reconstr Surg 128(6):728e–e732CrossRefGoogle Scholar
  11. 11.
    Mannucci PM (2012) Desmopressin (DDAVP) in the treatment of bleeding disorders treatment of hemophilia No 11, WFHGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Authors and Affiliations

  1. 1.Department of Plastic and Reconstructive Surgery, Faculty of MedicineTehran University of Medical SciencesTehranIran
  2. 2.Department of Plastic and Reconstructive Surgery, Faculty of MedicineMazandaran University of Medical SciencesSariIran
  3. 3.Department of Anesthesiology, Faculty of MedicineTehran University of Medical SciencesTehranIran
  4. 4.Valiasr HospitalImam Khomeini Hospital ComplexTehranIran

Personalised recommendations