There have been many attempts at identifying substances and describing
methods that would assist the surgeon and be of benefit to the patien
t undergoing a tonsillectomy. The use of bismuth subgallate as a haemo
static adjunct during tonsillectomy has only been described previously
in retrospective studies. A controlled prospective randomized trial o
f 100 paediatric patients, in which 50 patients had a tonsillectomy pe
rformed using bismuth subgallate as a haemostatic agent and in which t
he remainder did not have any associated haemostatic substance, is pre
sented here. Data on 72 patients was analysed, 39 patients belonging t
o the bismuth subgallate group and the remaining 33 to the control gro
up. The time for haemostasis was three to 18(mean 7.8) minutes in the
bismuth group. It was four to 16 (mean 9.9) minutes in the non-bismuth
group. These figures are statistically significant. The range of ties
used in the bismuth group was none to three (mean 1.5) ties and one t
o seven (mean 3.4) ties in the non-bismuth group. These figures are al
so statistically significant. The remainder of the recorded parameters
did not differ significantly. It was found that bismuth subgallate/ad
renaline paste decreases operating time by significantly reducing the
haemostasis time and the number of ties required but does not decrease
post-operative morbidity.