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Does bismuth subgallate have haemostatic effects in tonsillectomy?
W T Sørensen1, J Henrichsen, P Bonding
1Department of Otolaryngology, Glostrup Hospital, Copenhagen, Denmark.
Clinical Otolaryngology and Allied Sciences
|April 10, 1999
Summary
Bismuth subgallate gauze did not significantly reduce bleeding or improve hemostasis during tonsillectomy when used alone. Previous positive results may be due to adrenaline, not the bismuth subgallate itself.
Area of Science:
- Otolaryngology
- Surgical Hemostasis
- Pharmacology
Background:
- Previous studies suggest bismuth subgallate gauze aids hemostasis in tonsillectomy.
- These studies utilized bismuth subgallate in conjunction with adrenaline.
Purpose of the Study:
- To evaluate the efficacy of bismuth subgallate alone as a hemostatic agent during tonsillectomy.
- To determine if bismuth subgallate independently reduces bleeding or operative time.
Main Methods:
- A randomized clinical trial involving 204 patients undergoing tonsillectomy.
- Patients were randomized to receive gauze swabs with bismuth subgallate (n=106) or plain gauze swabs (n=98).
- Key outcomes measured included operative time, time to hemostasis, blood loss, and postoperative hemorrhage incidence.
Main Results:
- No statistically significant differences were observed between the bismuth subgallate group and the control group in any of the measured parameters.
- This indicates that bismuth subgallate alone did not improve hemostasis or reduce bleeding.
Conclusions:
- The evidence supporting the use of bismuth subgallate as an independent hemostatic agent in tonsillectomy is weak.
- The hemostatic effects observed in prior studies are likely attributable to the co-administered adrenaline.