Trend of haemostatic agent use in parotidectomy and thyroidectomy and its association with increased...

The use of topical haemostatic agents in head and neck surgery has increased. Although generally considered safe, concerns have arisen about potential associations with postoperative complications.

This study aims to evaluate whether haemostatic agent use in parotidectomy and thyroidectomy is associated with increased risk of seroma or postoperative infection.

A retrospective cohort study was conducted on patients who underwent parotidectomy between 2017-2024 and thyroidectomy between 2022-2024.

82, 31, 35 and 15 patients underwent drainless parotidectomy (DLP), drained parotidectomy (DP), drainless thyroidectomy (DLT) and drained thyroidectomy (DT) respectively. Haemostatic agent use was the only significant factor associated with increased risk of seroma/sialoma in parotidectomy (OR3.58, p = 0.02). No seroma occurred in patients who underwent thyroidectomy. Haemostatic agent use was associated with higher risk of post-parotidectomy infection (OR 6.74, p = 0.01), but this may be confounded since all infections occurred in DLP where these agents were more commonly used. Further analysis found a weak, non-significant association (Cramer's V = 0.20, p = 0.07). Concurrent neck dissection was the only significant predictor of post-thyroidectomy infection (OR6.33, p = 0.04).

Haemostatic agent use in parotidectomy is associated with increased seroma/sialoma risk and potentially infection risk, particularly when drains are omitted.