Postoperative outcome of palatine tonsillectomy by tonsil pillar suture with knot-free suture

Postoperative haemorrhage following palatine tonsillectomy occurs in 5-14% of cases. Since 2021, our department has used knot suturing with 3-0 Vicryl, and from 2023, continuous suturing with the V-Loc^™ closure device to reduce suture time. While knot suturing is reported to reduce postoperative bleeding and pain, no studies have compared outcomes between different suture methods.

This study retrospectively analysed postoperative bleeding, pain, and complications in 125 patients undergoing palatine tonsillectomy, with or without sutures.

Patients aged ≥15 years who underwent bilateral tonsillectomy from October 2019 to March 2024 were grouped into no-suture, knot-suture, and knot-free-suture categories. Data on operative time, pain, bleeding, suture dissection, and complications were compared using the Mann-Whitney U test for continuous variables and the chi-square test for nominal variables.

Knot-free sutures had the shortest operative time (53 ± 16 min) compared to no sutures (62 ± 19 min) and knot sutures (94 ± 22 min). Pain decreased over time across all groups. Bleeding rates were similar, though knot-free sutures required frequent removal (76%). Knot sutures had a significantly lower dissection rate (<0.001).

Knot-free sutures improve surgical efficiency but may require additional postoperative interventions, representing a cost-effective alternative to high-energy devices.