REDUCING POST OPERATIVE BLEEDING AFTER TONSILLECTOMIES IN CHILDREN BY MODIFYING THE MONOPOLAR DIATHERMY TECHNIQUE: A STUDY OF 1500 PATIENTS

Objective: To evaluate the effects of modifications of the present technique of monopolar diathermy tonsillectomy on the incidence of post operative bleeding and compare them with international data for tonsillectomies done without modifications. Methodology: This is a prospective, longitudinal experimental study. Fifteen hundred patients were studied from January 2000 to January 2008. Patient’s age ranged from five to fifteen years. All patients underwent tonsillectomies by modified monopolar diathermy method. The incidence of postoperative bleeding was assessed. Results: Two patients developed significant secondary haemorrhage, which is defined as requiring a return to the operating theater for the control of bleeding. One patient with secondary bleed required blood transfusion in addition to a return to the operating theater. Five patients developed minor secondary bleed that was controlled by conservative means. Two patients developed reactionary bleeding that was controlled in the operating room before return of the patient to the bed. Conclusion: Modifications in the existing technique produces a significantly lower incidence of post operative bleeding from the tonsillar fossae and compares well than those reported in the international literature.