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Pigs to the rescue: How salt pork stops nose bleeds

pig-214349_640With all the talk this week of Nobel Prizes, another recent prize won by a Stanford physician escaped notice. To secure this prize for inventive research in medicine, Stanford otolaryngologist Ian Humphreys, MD, didn't need access to laboratories packed with MRIs and supercomputers or a team of never-sleeping postdocs. His experimental design couldn't be called elegant or complex - or perhaps even an experiment at all.

He won for simply deploying a nasal pork tampon. Yes, you read that correctly: He stuck bacon in the bleeding nose of a small girl, and took home the 2014 IgNobel Prize in Medicine.

"We are squealing with pride," Robert Jackler, MD, chair of Stanford otolaryngology department, wrote to me. "We only wish that the work for which he is so deservedly honored was actually done at Stanford, but we would not want to hog the glory [from] a distinguished university in Michigan."

Oh, dear. Before your eyes glaze over with bad-piggy puns, here's the thing: The nasal tampon worked — twice.

Humphreys was working with a team at Michigan State University when a 4-year-old girl came into the Children's Hospital of Michigan with a bloody nose. The girl had a rare platelet bleeding disorder called Glanzmann thrombasthenia, which can cause fatal internal and nasal bleeding and bruising. To treat her nosebleed, the doctors applied pressure, gave her a clotting protein and sent her home.

She returned the next day, "a pale, ill-appearing child in moderate distress… with brisk bleeding" from the nose, according to the winning paper, "Nasal packing with strips of cured pork as treatment for uncontrollable epistaxis in a patient with Glanzmann thrombasthenia" from the Annals of Otology, Rhinology and Laryngology.

The team whisked her into surgery and inserted  a specialized dressing to control the bleeding. Two days later, however, the bleeding started again. The girl received a transfusion and they continued monitoring her. They took her back in surgery the next day, applying another type of packing material and a coagulating serum. They also gave another dose of coagulating proteins and a red blood transfusion. She remained intubated to allow her nasal cavity to heal.

Two days later, when doctors began to remove the packing material, bleeding began immediately. Quickly, they reapplied the high-tech gauze and upped her dose of coagulation protein. She remained hospitalized, sedated. Five days later, the team again tried to remove the packing. Again, the nosebleed returned.

"At this time, strips of cured salt pork were placed in both nasal vaults," Humphreys and his colleagues wrote. Three days later, "the bleeding was significantly less evident than it had been on all previous postoperative evaluations." Go pork!

About a month later, the little girl fell on her face, again causing a nose bleed. This time, the team whipped out the pork right away - bye, bye nosebleed.

It turns out this isn't the first time salt pork has been used to control a nosebleed. "It's a traditional therapy for hard to treat bleeding disorders," Jackler told me. "When I was a resident in the 1980s, we would buy a lump of salt pork to use."

The salt-packed pork is thought to work by inducing swelling, thereby blocking the bleeding blood vessel.

"It is not ignorant, even though they deem it ignoble," Jackler said.

Previously: Ten-year-old YouTube star: Famous for her singing, not for her illness, Stanford physicians and engineers showcase innovative health-care solutions and Stanford chair of otolaryngology discusses future regenerative therapies for hearing loss
Photo by Mutinka

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