alexa Avoidance of primary post-tonsillectomy hemorrhage in a teaching program.


Tropical Medicine & Surgery

Author(s): Conley SF, Ellison MD

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Abstract OBJECTIVE: To determine the incidence of primary post-tonsillectomy hemorrhage in a teaching institution by using a uniform technique, including a 3-minute relaxation of retraction before case termination and the use of bismuth subgallate. DESIGN: Case series. SETTING: Tertiary care academic pediatric center. PATIENTS: A 7-year retrospective study was performed by using the medical records of 1286 children without a bleeding abnormality who underwent tonsillectomy (with or without adenoidectomy). A uniform technique, proposed to reduce hemorrhage, was used for 705 children and was not used for 581 children. RESULTS: No episodes of primary hemorrhage (onset < or = 24 hours after surgery) occurred, and the incidence of delayed hemorrhage (onset >24 hours after surgery) was 1.1\% in the study group. The primary hemorrhage rate of the study group was significantly lower (P = .007) than the rate for the reference group (0.0\% vs 1.0\%), as was the total hemorrhage rate (1.1\% vs 4.1\%) and the delayed hemorrhage rate (1.1\% vs 3.1\%). CONCLUSION: A uniform technique including the use of bismuth subgallate and reassessment of the tonsillar fossae after a 3-minute observation period reduces the incidence of primary tonsillar hemorrhage in a teaching institution setting.
This article was published in Arch Otolaryngol Head Neck Surg and referenced in Tropical Medicine & Surgery

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