Intraoperative platelet-rich plasma in tonsillectomy: A randomized controlled trial of pain and wound-healing...

To evaluate whether topical autologous platelet-rich plasma (PRP) applied to the tonsillar fossae reduces postoperative pain and improves wound healing after bilateral tonsillectomy.

In this prospective randomized controlled trial with blinded patients and postoperative outcome assessors, 200 patients undergoing bilateral tonsillectomy were randomized 1:1 to receive topical autologous PRP or control treatment. The primary endpoint was postoperative pain trajectory over days 1-10 measured using a visual analog scale (VAS). Secondary endpoints were wound healing, complete mucosal healing by day 14, post tonsillectomy hemorrhage, and postoperative complications. Pain trajectory was analyzed using a repeated-measures mixed effects model.

Of 200 randomized patients, 195 contributed evaluable post-baseline data, with no significant baseline differences between groups. In the primary repeated-measures analysis, the PRP group showed lower postoperative pain over days 1-10 than the control group (difference: -0.8 VAS units; 95% CI, -1.2 to -0.4; p = 0.001). Wound healing was significantly better in the PRP group on postoperative days 7, 10, and 14, and complete mucosal healing by day 14 was more frequent with PRP (78% vs 59%; absolute difference 18.8 percentage points, 95% CI 6.0 to 31.6). Secondary hemorrhage rates did not differ significantly between groups (2.0% vs 5.2%; p = 0.28). No serious adverse events occurred.

Topical autologous PRP applied during tonsillectomy was associated with reduced postoperative pain and improved wound healing compared with control treatment. PRP may be a useful adjunct for enhancing early recovery after tonsillectomy.