Does the local application of Platelet-Rich Plasma Reduce Hemorrhage after Tonsillectomy? A Comparative Study

Authors

DOI:

https://doi.org/10.32007/jfacmedbagdad.2153

Keywords:

Tonsillectomy, post-tonsillectomy hemorrhage, topical application of platelet-rich plasma

Abstract

Background: Tonsillectomy is one of the most common surgical operations in otolaryngology, post-tonsillectomy hemorrhage is a dangerous complication. Several methods have been used to decrease the rate of post-tonsillectomy hemorrhage, one of these methods, a relatively recent method, is local application of platelet-rich plasma (PRP) to the tonsillar beds.

Objectives: To evaluate the role of local application of autologous PRP to the tonsillar beds, at the time of tonsillectomy, in post-tonsillectomy hemorrhage.

Patients and methods: A prospective comparative study enrolled 64 patients with ages ranging from 6 to 10 years who underwent tonsillectomy with or without adenoidectomy. In each patient, PRP was applied at the time of tonsillectomy to one tonsillar bed (PRP side), while the other side was used as a control side. So, the total sides were 128 (64 PRP and 64 control sides). The patients were followed-up for 10 days and the outcome measure was the occurrence of post-tonsillectomy hemorrhage on the PRP side versus the control side. The association between the variables was established using chi-square test (X2-test).

Results: Thirty-eight patients (59.4%) were males and twenty-six patients (40.6%) were females. Adenotonsillectomy was performed in 35 patients (54.7%), while 29 patients (45.3%) underwent tonsillectomy alone. There was no post-operative hemorrhage from the adenoid beds. Post-tonsillectomy hemorrhage occurred in 1 patient (1.6%) on the PRP side and 3 patients (4.7%) on the control side (P-value=0.31).

Conclusions: The local application of autologous PRP to the tonsillar bed only once, at the time of tonsillectomy, is not significantly effective in reducing post-tonsillectomy hemorrhage.

 

Received: Jun. 2023

Accepted: July, 2023

Published: Oct .2023

Downloads

Download data is not yet available.

References

Nunez D.A., Provan J, Crowford M. Post-operative tonsillectomy pain in pediatric patients. Arch Otolaryngology Head and Neck Surg. 2000; 126:837-41. https://doi.org/10.1001/archotol.126.7.837.

Ding XX, Zhao LQ, Cui XG, Yin Y, Yang HA. Clinical observation of softpalate-pharyngoplasty in the treatment of obstructive sleep apnea hypopnea syndrome in children. World J Clin Cases. 2020; 8:679-88.

https://doi.org/10.12998/wjcc.v8.i4.679.

Østvoll E, Sunnergren O, Stalfors J. Increasing Readmission Rates for Hemorrhage after Tonsil Surgery: A Longitudinal (26 Years) National Study. Otolaryngol Head Neck Surg. 2018; 158:167-76. https://doi.org/10.1177/0194599817725680.

Sakki A, Mäkinen LK, Roine RP, Nokso-Koivisto J. Changing trends in pediatric tonsil surgery. Int J Pediatr Otorhinolaryngol. 2019; 118:84-89. https://doi.org/10.1016/j.ijporl.2018.12.028.

Tomkinson A, Harrison W, Owen D, Harris S, McClure V, Temple M. Risk factors for postoperative hemorrhage following tonsillectomy. Laryngoscope. 2011; 121:279-88. https://doi.org/10.1002/lary.21242.

Attner P, Haraldsson PO, Hemlin C, Hessen Soderman AC. A 4-year consecutive study of post-tonsillectomy hemorrhage- ORL J Otorhinolaryngol Relat Spec. 2009; 71:273-78. https://doi.org/10.1159/000245160.

Sanchez AR, Sheridan PJ, KuppLI. Is platelet-rich plasma the perfect enhancement factor? A Current Review. International Journal of Oral & Maxillofacial Implants. 2003; 18(1):93-103. PMID: 12608674

Man D, Plosker H, Winland-Brown J. The use of autologous platelet-rich plasma and autologous platelet-poor plasma in cosmetic surgery. Plast Reconstr. 2001; 107:229-37.https://doi.org/10.1097/00006534-200101000-00037.

Fernandez-Moure JS, Van Eps JL, Cabrera FG, Barbosa Z, Del Rosal GM, Weiner BK, et al. Platelet-rich plasma: A biomimetic approach to enhancement of surgical wound healing. J Surg Res. 2017; 207:33-44. https://doi.org/10.1016/j.jss.2016.08.063.

Salah Eldin AHS. Role of platelet-rich plasma to decrease post-tonsillectomy pain and bleeding. The Medical Journal of Cairo University. 2011; 175-78.

Nanditha S, Gopalakrishnan S, Karthikeyan P, Bakshi SS. Efficacy of topical application of autologous platelet-rich plasma in adult tonsillectomy patients: a randomized control study. The Journal of Laryngology & Otology. 2021; 135(6):539-44. https://doi.org/10.1017/S0022215121000402.

Albazee E,Diab S, Awad AK, Aboeldahab H, Abdella WS, Abu-Zaid A. The analgesic and anti-hemorrhagic effect of platelet-rich plasma in tonsillectomy: a systematic review and meta-analysis of randomized controlled trials. Clinical Otolaryngology.2023; 48(1):1-9. https://doi.org/10.1111/coa.13977.

Eby BW. Platelet-rich plasma harvesting with a single spin centrifuge. J Oral Implant. 2002

https://doi.org/10.1563/1548-1336(2002)028<0297:PPHWAS>2.3.CO;2

Sonnleitner D, Huemer P, Sullivan DY. A simplified technique for producing platelet-rich plasma and platelet concentrate for intraoral bone grafting: A technical note. Int J Oral Maxillofacial Implant. 2000; 15:879-82. PMID: 11151589.

Krishna P, Lee D. Post-tonsillectomy bleeding: A meta-analysis. Laryngoscope. 2001; 111:1358-61. Doi: 10.1097/00005537-200108000-00008. PMID: 11568568

https://doi.org/10.1097/00005537-200108000-00008.

Theilgaard SA, Nielson HU, Siim C. Risk of hemorrhage after outpatient versus inpatient tonsillectomy. Ugeskrift for Laeger. 2001; 163:5002-5. PMID: 11573376

Clark CM, Schubart JR, Carr MM. Trends in the management of post-tonsillectomy hemorrhage in children. Int J Pediatr Otorhinolaryngol. 2018; 108:196-201. doi: 10.1016/j.ijporl.2018.03.004. PMID: 29605354

https://doi.org/10.1016/j.ijporl.2018.03.004.

Tolska HK, Takala AJ, Jero J. Peritonsillar infiltration of lidocaine with adrenaline is associated with increased risk of secondary post-tonsillectomy haemorrhage. J Laryngol Otol. 2018; 132:911-22. https://doi.org/10.1017/S0022215118001731.

Morris S, Hassin E, Borschmann M. Overnight in-hospital observation following tonsillectomy: retrospective study of post-operative intervention. J Laryngol Otol. 2018; 132:46-52. doi: 10.1017/S0022215117002171. PMID: 29103384

https://doi.org/10.1017/S0022215117002171.

Liu L, Rodman C, Worobetz NE, Johnson J, Elmaraghy C, Chiang T. Topical biomaterials to prevent post-tonsillectomy hemorrhage. J Otolaryngol Head Neck Surg. 2019; 48(1):45. https://doi.org/10.1186/s40463-019-0368-1

https://doi.org/10.1186/s40463-019-0368-1.

Suthar M, Gupta S, Bukhari S, Ponemone V. Treatment of chronic non-healing ulcers using autologous platelet rich plasma: a case series. J Biomed Sci.2017; 24: 16. https://doi.org/10.1186/s12929-017-0324-1

https://doi.org/10.1186/s12929-017-0324-1.

Lana JFSD, Santana MHA, Belangero WD, Luzo ACM. Platelet-Rich Plasma - Regenerative Medicine: Sports Medicine, Orthopedic, and Recovery of Musculoskeletal Injuries. 2014. https://www.springer.com /gp/book/9783642401169 https://doi.org/10.1007/978-3-642-40117-6.

Mohammed S, Yu J. Platelet-rich plasma injections: an emerging therapy for chronic discogenic low back pain. J Spine Surg. 2018 Mar; 4(1):115-22. doi: 10.21037/jss.2018.03.04. PMID: 29732431; PMCID: PMC5911760

https://doi.org/10.21037/jss.2018.03.04.

Srinivasa V, Muthu Ramanathan AN, Nanditha S, Sandravelu T, Dharshana G, Ajmal A. Role of platelet-rich plasma in post-tonsillectomy pain. European Journal of Molecular & Clinical Medicine. 2023:10(1):162-71.

Saad HAE, Mandour MF, Behery AS, Sheleb WA. Determining the impact of platelet-rich plasma on short-term postoperative outcomes of pediatric tonsillectomy patients in Egypt. Journal of Advances in Medicine and Medical Research. 2021; 33(22):1-7. DOI:https://doi.org/10.9734/jammr/2021/v33i2231153

https://doi.org/10.9734/jammr/2021/v33i2231153.

Kutuk SG, Ozdas T. The impact of platelet-rich plasma therapy on short-term postoperative outcomes of pediatric tonsillectomy patients. European Archives of Oto-Rhino-Laryngology. 2019; 276:489-95. https://doi.org/10.1007/s00405-018-5211-1.

Chettri M, Jayagandhi S, Konyak Y, Sobita P, Singh M, Singh A. Hemostasis and analgesia with autologous platelet-rich plasma in tonsillectomy.The Journal of Laryngology & Otology. 2019; 133(7):615-21. https://doi.org/10.1017/S0022215119001488

Downloads

Published

2023-10-01

How to Cite

1.
Rasheed AM. Does the local application of Platelet-Rich Plasma Reduce Hemorrhage after Tonsillectomy? A Comparative Study. JFacMedBagdad [Internet]. 2023 Oct. 1 [cited 2024 May 2];65(3):187-91. Available from: https://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/2153

Publication Dates

Similar Articles

1-10 of 202

You may also start an advanced similarity search for this article.