SURGICALLY TREATED AFTERBLEEDING FOLLOWIN G TONSILLECTOMY

Background: Bleeding after tonsillectomy is the most frequent and most dangerous complication, We compared the incidence of postoperative bl eeding and secondary haemorrhage after tonsillectomy was examined usin g two methods of hemostasis (suture ligation versus electrocautery). M ethods: The study covered all tonsillectomies performed from 1992 to 1 994. Data from about 2096 patients were assessed. Results: The inciden ce of postoperativ bleeding and hemorrhage was 5.4%. When suture ligat ion of vessels was used to obtain hemostasis during the operation it w as evident that postoperative bleeding was rare but more difficult in comparison to the cases in which electrocautery was used alone. While primary bleeding for both methods was similar, secondary bleeding was more frequent after hemostasis achieved with electrocautery. Discussio n: Injury of the vessel by suture ligation is thought to be responsibl e for massive hemorrhage after tonsillectomy. Using electrocautery avo ids this pathogenic mechanism. Since electrocautery of the tissue surr ounding a vessel produces initial hemostasis, secondary bleeding is mo re frequent after the wound clot is opened. Conclusion: Use of electro cautery for hemostasis is justified since bleeding after primary hemos tasis is usually easily managed.