Merocel sponges are the most appropriate initial nasal packing material for anterior epistaxis because they provide effective, atraumatic, and uniform pressure to the anterior nasal mucosa, which helps achieve hemostasis. They are synthetic, non-adherent, and easy to insert and remove, causing less mucosal trauma compared to cotton or petroleum gauze. Additionally, Merocel sponges absorb blood and expand, maintaining consistent pressure within the nasal cavity without the risks associated with balloon catheters, which are reserved for posterior packing. This makes them ideal as a first-line choice in controlling anterior nasal bleeding.

Reference: Cummings Otolaryngology – Head and Neck Surgery, 7th Edition.