Tissue Welding Reduces Pain and Bleeding in Tonsillectomy Patients

A new study has found that tissue-welding technology in total tonsillectomy patients resulted in significantly less intraoperative blood loss and lower pain scores compared to cold dissection tonsillectomy.

Researchers at General Hospital Volos (Greece) randomized 32 adults with recurrent tonsillitis who were scheduled for elective tonsillectomy to either the tissue welding technique or to the cold dissection technique, with 16 patients in each group. The researchers estimated intraoperative blood loss by measuring the amount in the suction bottle and by weighing the cotton pledgets before and after the procedures. The patients were discharged the day after surgery with an acetaminophen prescription for pain control and a chart to record the following factors on a daily basis for 10 days following surgery: intensity of post-operative pain, total analgesic requirements, last day of taking analgesics, and any other adverse events.

The researchers found that the rate of intraoperative blood loss was significantly lower in the tissue-welding group, with essentially no intraoperative bleeding observed. In addition, patients in the tissue-welding group showed a general trend toward lower pain scores, with the difference being statistically significant from the first to the fourth post-operative days. Tissue welding demonstrated the greatest improvement in pain over cold dissection on the first post-operative day; a difference of 2.3 points on a 10-point scale. The study was published in the August 2007 issue of the Annals of Otology, Rhinology & Laryngology.

"Tissue-welding tonsillectomy is a new innovation that appears to provide a valuable addition to our surgical armamentarium for reducing the postoperative morbidity that is usually experienced after total tonsillectomy,” concluded lead researcher Pelagia Stavroulaki, M.D, Ph.D, of the department of otorhinolaryngology. "The results provide evidence that patients treated with the tissue welding tonsillectomy may experience improved quality of recovery.”

Tissue welding is a sutureless method of wound closure that has been used successfully in nerve, skin, and arterial anastomoses. After heating generated by laser exposure, a glue is formed between tissue edges that forms a weld upon cooling. The advantages of laser welding over traditional wound closure are no foreign body reaction and less scar formation.


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