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Published on: April 2, 2017
[Gelatin-thrombin matrix-mediated hemostasis: application in tonsillectomy]
1Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde/Plastische Operationen, Universität Leipzig, Liebigstrasse 10-14, 04103, Leipzig, Deutschland. christian.mozet@medizin.uni-leipzig.de
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.
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