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References

Crossland G, Bath A. Bismuth iodoform paraffin paste: a review. J Laryngol Otol. 2011; 125:891-895
Balasubramanian T, Bleacher L. BIPP Pack a revisit. J Otolaryngol. 2011; 1:1-2
Gurd FB, McKim LH. BIPP and liquid paraffin treatment of war and civilian wounds. Ann Surg. 1941; 113:987-1000
Agrawal R, Sangle A, Vyawahare A. Bismuth Iodoform and paraffin paste a boon in treatment of keratocystic odontogenic tumor: a case report. J Dent Med Res. 2014; 1:32-35
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Charlu AP Kumar S, Chacko R. Qualitative evaluation of ‘BIPP dressing’ for intraoral mucosal defect. J Clin Diagn Res. 2018; 12:11-14
Coulson CJ, Pothier DD, Lai P, Rutka JA. Bismuth iodoform paraffin paste hypersensitivity reactions in mastoid cavities following isolation of mucosal lining: a series of 587 patients. J Laryngol Otol. 2012; 126:240-243
EMC. Bismuth subnitrate and iodoform paste impregnated gauze. 2015. https://www.medicines.org.uk/emc/product/3691/smpc#gref (accessed March 2021)
Atwal A, Cousin GC. Bismuth toxicity in patients treated with bismuth iodoform paraffin packs. Br J Oral Maxillofac Surg. 2016; 54:111-112
Hartley C, Ng KL, Jackson A. CT and MR appearance of otolaryngologic packing materials. AJNR Am J Neuroradiol. 1995; 16:1697-1702
Nigam A, Allwood MC. BIPP – how does it work?. Clin Otolaryngol Allied Sci. 1990; 15:173-175
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Bismuth Iodoform Paraffin Paste: History, Uses and Alternatives in Oral and Maxillofacial Surgery

From Volume 48, Issue 3, March 2021 | Pages 207-211

Authors

Gurpreet Kaur Randhawa

BDS(Hons) MFDS, RCS(Ed)

Dental Core Trainee, North Manchester General Hospital

Articles by Gurpreet Kaur Randhawa

Email Gurpreet Kaur Randhawa

Richard M Graham

BDS, FDSRCS(Eng), MBChB, MRCS(Ed), FRCS(OMFS)(Ed)

Specialist Registrar, Oral and Maxillofacial Surgery Department, North Manchester General Hospital, Manchester, UK

Articles by Richard M Graham

Karanveer Singh Matharu

BDS(Hons) MFDS RCS(Ed)

Dental Core Trainee, Northwick Park Hospital, London

Articles by Karanveer Singh Matharu

Abstract

Bismuth iodoform paraffin paste (BIPP) continues to be widely used in dental/oral and maxillofacial/ENT surgery for surgical cavity packing and wound dressing where pressure, antisepsis and haemostasis is required. We present information on its history and uses, including historical use, constituents, uses in surgery, risks and considerations for deciding on its use. Although side effects and adverse reactions have been reported, these are rare.

CPD/Clinical Relevance: BIPP is commonly used in surgical procedures and an appreciation of its background, history, uses and side effects are important as well as an understanding of its alternatives.

Article

Bismuth iodoform paraffin paste (BIPP) is commonly used in dental and surgical applications as a wound dressing, for cavity packing, as well as in ear, nose and throat procedures, when pressure, antisepsis and/or haemostasis is required. It commonly comes in the form of a paste or impregnated sterile gauze (Figure 1).1 Clinicians also use BIPP paste dressing in a range of oral and maxillofacial surgical procedures.

BIPP was first used by Rutherford Morison in 1916 to dress soldiers' wounds.2 He found that when bismuth and iodoform were mixed with paraffin, it permitted a healing response and reduced infection rates. His recommendations were as follows:

Excess BIPP was then removed as incomplete removal of excess paste commonly resulted in failure.

This was described for use in World War I to treat gunshot wounds, and since then, BIPP has continued to be used as a wound packing material.3

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