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Paper Information

Journal:   JOURNAL OF ISFAHAN MEDICAL SCHOOL (I.U.M.S)   Spring-Summer 2005 , Volume 23 , Number 76-77 (Special English Edition); Page(s) 28 To 30.
 
Paper: 

A COMPARISON BETWEEN TONSIL DISSECTOR (FISHER KNIFE) AND WIRE SNARE IN INTRA- AND POST-TONSILLECTOMY BLEEDING AND SUTURE LLGATION

 
 
Author(s):  BALUCHI M., BERJIS N.A.D., OMRANI M.R.*
 
* Department of Otolaryngology, Isfahan University of Medical Sciences, Isfahan, Iran
 
Abstract: 

INTRODUCTION: Tonsillectomy is among the most commonly performed surgical procedures and bleeding is the most common complication of this operation. Based on a physiological principle, blunt dissections tend to cause less bleeding compared with sharp dissections, hence the authors arranged a study to compare tonsil dissector (Fisher knife) and loop of wire snare in respect of intra- and post-operative bleeding as they are used to transect the tonsils from their inferior pole.
METHODS: In a randomized clinical trial of 90 cases admitted for tonsillectomy to Al-Zahra and Kashani Hospitals, both techniques were used on every patient in removal of palatine tonsils. After packing, active bleedings of the tonsillar fossae, especially in the inferior pole were ligated using 2-0 catgut. The cases were observed for 24 hours for any probable postoperative bleeding before being discharged. The patients were re-examined 7 days after the operation.
RESULTS: Despite no statistically significant difference between the two tonsillectomy techniques as regards intra- and post-operative bleeding (P=0.08), the use of tonsil dissector was associated with less intraoperative bleeding that would require suture ligation and the difference was statistically significant (P=0.049).
DISCUSSION: The use of tonsil dissector (Fischer knife) was associated with significantly less intraoperative bleeding leading to suture ligation than loop of wire snare. This finding is consistent with a preexisting physiological principle stating that blunt dissections tend to lead to less bleeding as compared to sharp dissections.

 
Keyword(s): TONSILLECTOMY, FISHER KNIFE, LOOP OF WIRE SNARE, BLEEDING
 
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