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Reusable versus disposable instruments in tonsillectomy: a comparative study of outcomes
A Maheshwar1, M De, S T Browning
1Department of Otolaryngology and Head & Neck Surgery, Singleton Hospital, Swansea, Glamorgan.
International Journal of Clinical Practice
|October 8, 2003
Summary
Disposable tonsillectomy instruments (DIs) may increase complication risks, including hemorrhage, compared to reusable instruments (RIs). This study highlights significantly higher rates with DIs, especially when diathermy is used.
Area of Science:
- Otolaryngology
- Surgical Safety
- Infection Control
Background:
- Tonsillectomy traditionally uses reusable instruments (RIs).
- Disposable instruments (DIs) are increasingly used to mitigate theoretical risks of variant Creutzfeldt-Jakob disease transmission.
- Concerns exist regarding potential increased complication rates with DIs.
Purpose of the Study:
- To audit and compare complication rates between tonsillectomies performed with RIs and DIs.
- To specifically analyze postoperative hemorrhage rates.
- To investigate the impact of diathermy use within DI procedures.
Main Methods:
- Retrospective audit of 200 tonsillectomy cases (100 RIs, 100 DIs).
- Analysis of overall complication rates and postoperative hemorrhage rates.
- Comparison between RI and DI groups, including diathermy subgroups.
Main Results:
- Overall complication rate: 6% for RIs vs. 33% for DIs.
- Hemorrhage rate: 1% for RIs vs. 12% for DIs.
- DI group showed significantly higher complication and hemorrhage rates, particularly in the diathermy subgroup.
Conclusions:
- Disposable instruments (DIs) are associated with significantly higher complication and hemorrhage rates in tonsillectomy compared to reusable instruments (RIs).
- Diathermy use in conjunction with DIs further elevates these risks.
- This is the first study to report on complications specifically linked to disposable tonsillectomy instruments.