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Effectiveness of bismuth subgallate for preventing bleeding following adenotonsillectomy: A multicentre study

Andrea Trombetta1, Irene Sanson2, Egidio Barbi3

  • 1University of Trieste, Italy; Ospedale Santa Maria degli Angeli, Pordenone, Italy.

American Journal of Otolaryngology
|December 23, 2023
PubMed

Insights

Bismuth subgallate (BS) significantly reduced postoperative bleeding after tonsillectomy and adenotonsillectomy in children. This study supports BS as a safe and effective option for preventing this common complication.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Surgical Hemostasis

Background:

  • Tonsillectomy and adenotonsillectomy are common procedures with a risk of postoperative bleeding (PTH).
  • Bismuth subgallate (BS) has been used as a hemostatic agent, but its efficacy and safety in pediatric patients remain debated.

Purpose of the Study:

  • To evaluate the effectiveness and safety of bismuth subgallate (BS) in preventing postoperative bleeding (PTH) in children undergoing tonsillectomy and adenotonsillectomy.

Main Methods:

  • A retrospective, multicenter study comparing two cohorts of children (0-18 years) undergoing tonsillectomy/adenotonsillectomy.
  • The active group received BS with gauze swabs; the control group did not.
  • Key outcomes analyzed included PTH prevalence, complications, and hospital readmissions within 30 days.

Main Results:

  • A total of 4,744 children were analyzed (2,598 active group, 2,146 control group).
  • The incidence of postoperative bleeding (PTH) was significantly lower in the active group (1.4%) compared to the control group (2.6%).
  • No neurological complications or aspiration pneumonia were observed in either group.

Conclusions:

  • Bismuth subgallate (BS) is a safe and effective agent for reducing severe postoperative bleeding (PTH) after tonsillectomy and adenotonsillectomy in children.
  • The findings support the use of BS as a reliable hemostatic option in pediatric tonsillectomy procedures.
Abstract

Keywords:
AdenotonsillectomyBismuth subgallatePostoperative bleeding

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