Measurement of the True Incidence of Secondary Haemorrhage Post
Tonsillectomy by Luke Holmes and Vik Veer* in Crimson Publishers: Surgery Open
Access Journal
Aim: To determine
the ‘true’ secondary haemorrhage
rate post-tonsillectomy.
Methods: A telephone survey was conducted of 127 consecutive patients who
had a tonsillectomy at the Freeman Hospital over a two-month period.
Results: 99 patients were contactable. There were 38 post-tonsillectomy
bleeds, 23 of which were minor and 15 significant. 23 bleeds went unreported
and four of these were significant. 11 percent of bleeds post-cold steel
tonsillectomy were significant, compared to 28 percent of bleeds post-diathermy dissection.
Conclusion: There is a high incidence of unreported bleeding (61 percent of
those that bled) and a third of adults who suffered a significant bleed did not
report it. Diathermy had a significantly higher proportion of significant
bleeds compared to cold steel. It is recommended if secondary haemorrhage rates
are reported in the literature then small studies should contact patients for
‘true’ secondary bleed rates while large studies should use return to theatre
and need for transfusion rates.
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