C Mozet1, C Prettin, M Dietze, A Dietz. 1. Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde/Plastische Operationen, Universität Leipzig, Liebigstrasse 10-14, 04103, Leipzig, Deutschland. christian.mozet@medizin.uni-leipzig.de
Abstract
BACKGROUND: To assess the feasibility of omitting thermal coagulation following cold knife tonsillectomy, we compared the use of a local thrombin hemostat (FloSeal®, FS) to bipolar electrocautery (EK). PATIENTS AND METHODS: A total of 181 patients with chronic tonsillitis or tonsillar hypertrophy were stratified in terms of patient characteristics and randomized before undergoing tonsillectomy. The follow-up period continued until postoperative day 20. RESULTS: FS-treated patients reported lower postoperative pain intensity scores (p = 0.011) and significantly reduced pain duration (p < 0.001). Whilst wound healing appeared to be improved in FS patients, the rates of postoperative hemorrhage remained unchanged. Use of an FS enabled inexperienced surgeons (< 100 procedures) to reduce their operating time by 8 min (p = 0.05), although no effect was observed for experienced surgeons. CONCLUSION: Hemostasis is effectively mediated by an FS and its application reduces postoperative pain intensity and duration. Although we observed accelerated wound healing and reduced operating times owing to a more calculable rate of hemostasis, this did not influence the rates of postoperative hemorrhage.
RCT Entities:
BACKGROUND: To assess the feasibility of omitting thermal coagulation following cold knife tonsillectomy, we compared the use of a local thrombin hemostat (FloSeal®, FS) to bipolar electrocautery (EK). PATIENTS AND METHODS: A total of 181 patients with chronic tonsillitis or tonsillar hypertrophy were stratified in terms of patient characteristics and randomized before undergoing tonsillectomy. The follow-up period continued until postoperative day 20. RESULTS:FS-treated patients reported lower postoperative pain intensity scores (p = 0.011) and significantly reduced pain duration (p < 0.001). Whilst wound healing appeared to be improved in FSpatients, the rates of postoperative hemorrhage remained unchanged. Use of an FS enabled inexperienced surgeons (< 100 procedures) to reduce their operating time by 8 min (p = 0.05), although no effect was observed for experienced surgeons. CONCLUSION: Hemostasis is effectively mediated by an FS and its application reduces postoperative pain intensity and duration. Although we observed accelerated wound healing and reduced operating times owing to a more calculable rate of hemostasis, this did not influence the rates of postoperative hemorrhage.
Authors: Alun Tomkinson; Wendy Harrison; David Owens; Susan Harris; Victoria McClure; Mark Temple Journal: Laryngoscope Date: 2010-11-16 Impact factor: 3.325
Authors: David G Neschis; Meyer R Heyman; Vasana Cheanvechai; Marshall E Benjamin; William R Flinn Journal: J Vasc Surg Date: 2002-02 Impact factor: 4.268