alexa Post-tonsillectomy hemorrhage: incidence, prevention and management.


Otolaryngology: Open Access

Author(s): Handler SD, Miller L, Richmond KH, Baranak CC

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Abstract Tonsillectomy (with or without adenoidectomy) continues to be a commonly performed operation in the United States. Over the years, the incidence of post-tonsillectomy hemorrhage (reported between 0\% and 20\%) has decreased, but continues to pose serious problems. We reviewed 1,445 tonsillectomies performed over a 2-year period to study the incidence of post-tonsillectomy hemorrhage. Thirty-eight of 1,445 children (2.62\%) had postoperative bleeding. The incidence of primary hemorrhage (within 24 hours) was 0.14\%. Delayed hemorrhage requiring operative intervention or observation in the hospital was 1.03\% and 0.76\%, respectively. Ten patients (0.69\%) had delayed hemorrhage of a minor nature that had stopped by the time they reached the hospital; these children were treated with observation alone and did not require hospitalization or operative intervention. The proposed reasons for this low rate of post-tonsillectomy hemorrhage include complete preoperative coagulation screening, meticulous attention to surgical technique, use of suction-cautery to obtain hemostasis and, possibly, use of postoperative antibiotics. Management of hemorrhage is discussed with respect to observation, surgical intervention, and blood transfusion.
This article was published in Laryngoscope and referenced in Otolaryngology: Open Access

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