Does topical use of autologous serum help to reduce post-tonsillectomy morbidity? A prospective, controlled preliminary study

Kara, Memduh; Erdoğan, Halil İbrahim; Altınışık, Hatice Betül; Aylanç, Hakan; Güçlü, Oğuz; Dereköy, Fevzi Sefa

doi:10.1017/s0022215116007970

Cited by 9 publications

(16 citation statements)

References 26 publications

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“…Throat ache is a complaint that frequently develops following tonsillectomy surgery and it may lead to undesired situations such as prolonged hospitalization, poor oral intake, dehydration, and late return to daily life. In the past, several agents were used to relieve pain following tonsillectomy [ 1 - 6 ] and they each have individual advantages and disadvantages. For that reason, there is currently not a consensus on relieving pain after tonsillectomy.…”

Section: Discussionmentioning

confidence: 99%

“…The pain persists until approximately 2–3 weeks as the pharyngeal muscles are covered by the mucosa. In order to relieve postoperative pain following tonsillectomy, several methods and medical therapeutic agents have been used such as hyaluronic acid [ 1 ], magnesium [ 2 ], opioid [ 3 ], honey intake [ 4 ], sucralfate in the tonsil region [ 5 ], and autologous serum [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Is Ginger Effective in Reducing Post-tonsillectomy Morbidity? A Prospective Randomised Clinical Trial

Kocak¹,

Yücepur²,

Gökler³

2018

Clin Exp Otorhinolaryngol

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Objectives An assessment of the effects of ginger on pain, nausea, vomiting, bleeding, and wound site healing that occur after tonsillectomy.Methods This prospective clinical study was participated by 49 patients aged 18–45 years out of 56 patients that underwent tonsillectomy and regularly attended follow-up visits. The patients were randomly divided into two groups. Group 1 consisted of 23 patients that used ginger capsules and group 2 consisted of 26 patients that did not use ginger capsules in addition to the routine antibiotic and paracetamol treatment following tonsillectomy. The pain, nausea, vomiting, and bleeding scores of patients were assessed on days 1, 4, 7, and 10 by using the visual analogue scale. Similarly, the epithelialization degrees of tonsillar bed were assessed on postoperative days 1, 4, 7, and 10 and regular oral intake times of patients were recorded.Results There were no differences between groups in terms of age and sex. On the postoperative days 1, 4, 7, and 10, the pain scores were lower in the group 1 (all P<0.001) and there were no differences between the two groups in terms of postoperative nausea, vomiting, and bleeding scores (P=0.35 and P=0.53). On the postoperative days 7 and 10, epithelialization in the tonsil bed was quicker in the group 1 (P=0.041 and P=0.026) and the regular oral intake time was earlier in group 1 (P<0.001).Conclusion In this study, ginger relieved pain, accelerated wound site epithelialization, and decreased duration of oral intake following tonsillectomy. It did not result in postoperative bleeding or any other complications. Ginger can be recommended as an adjunct to routine medical treatment for decreasing morbidity following tonsillectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is Ginger Effective in Reducing Post-tonsillectomy Morbidity? A Prospective Randomised Clinical Trial

Kocak¹,

Yücepur²,

Gökler³

2018

Clin Exp Otorhinolaryngol

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“…epithelisation and even cognitive dysfunction, may occur in patients after tonsillectomy (37). A previous study has reported that cognitive dysfunction may affect children for up to 6 months after the operation (13).…”

Section: Dex (Mg/kg) Adverse ----------------------------------------mentioning

confidence: 98%

Beneficial effects of dexmedetomidine on early postoperative cognitive dysfunction in pediatric patients with tonsillectomy

Han

2018

Exp Ther Med

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According to clinical investigations, early postoperative cognitive dysfunction is the most common adverse event in pediatric patients after tonsillectomy. A previous study has indicated that dexmedetomidine (DEX) is an efficient drug for the treatment of postoperative cognitive dysfunction. However, the efficacy of DEX in alleviating early postoperative cognitive dysfunction in pediatric patients following tonsillectomy has remained elusive, which was therefore assessed in the present study. A total of 186 children presenting with cognitive dysfunction subsequent to tonsillectomy were recruited to analyze the efficacy of DEX. Patients were randomly divided into two groups and received intravenous treatment with DEX (n=112) or placebo (n=74). Duration of treatment, dose-limiting toxicities (DLT) and maximum tolerated dose (MTD) of DEX were evaluated in a preliminary experiment. The improvement of postoperative cognitive function in children with tonsillectomy was analyzed with a Mini-Mental State Examination (MMSE) following treatment with DEX. A 40-item quality of life (MONEX-40) questionnaire was used to assess the efficacy of DEX. The plasma levels of interleukin (IL)-6, IL-1, tumor necrosis factor (TNF)-α, superoxide dismutase (SOD), neuron-specific enolase (NSE), C-reactive protein (CRP), cortisol and melatonin were also analyzed. The preliminary experiment determined that the DLT was 10 mg/kg and the MTD was 15 mg/kg. In the major clinical trial, it was revealed that MMSE scores in the DEX treatment group were markedly improved, indicating that DEX had a beneficial effect in pediatric patients with early postoperative cognitive dysfunction after tonsillectomy. In addition, IL-1and TNF-α were downregulated, while IL-6 and SOD were upregulated in patients with cognitive dysfunction after treatment with DEX compared with those in the placebo group. Furthermore, DEX treatment markedly decreased the serum levels of CRP, NSE cortisol and melatonin, which are associated with the occurrence of postoperative cognitive dysfunction in pediatric patients following tonsillectomy. In conclusion, intravenous administration of DEX at a dose of 10 mg/kg improves postoperative cognitive function in pediatric patients with tonsillectomy by decreasing the serum levels of inflammatory factors and stress-associated signaling molecules. Trial registration no. QLSDHOS0200810102C (Qilu Hospital of Shandong University, Jinan, China).

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“…Y Surgicel® [77]N for othersBismuth subgallate-basedBSG- adrenaline paste, BSG- phenylephrine hydrochloride mixtureY [78]Y (BSG mixed with phenylephrine hydrochloride) [79]Y BSG with adrenaline for primary PTH [80], N for secondary PTH [81]N [81]Clinical study on patients underwent tonsillectomy [78, 81]Spectrum Chemical (powder), mixing 26 g of BSG powder to 20 ml of normal saline with 0.7 ml of 1:1000 adrenalinePost-opdecreases operating time by significantly reducing the hemostasis time and the number of ligatures [78, 81]; accelerates the cascade of blood clotting [79]; accelerate the intrinsic clotting pathway through the activation of factor XII (Hageman factor) [82]. Y [62]Antifibrinolyticstranexamic acid (TXA) liquidY [83, 84]N [83, 84]–Clinical reports analysis of 246 patients topically treated with TA and 248 control [84]Systematic review [83]Cyklokapron®Postopno device or site for infection, reduce intraoperative blood loss during Orthognathic Surgery, prevent postop hemorrhage after oral or dental surgery in hemophilia A patients and those on warfarin anticoagulation [85]N for Topical applicationNatural materialPropolis–Y [86]Y [86]Randomized controlled study on 65 patients [86]Topical propolis gelgargle immediately after surgery [86]accelerated wound healing of tonsillar fossaeNHerbal ingredientsY [87]––Clinical trial in 47 consecutive children patientsAnkaferd Blood Stopper®Intra-opsafe and efficient, and it reduces operating time [87], and contains no synthetic additives [88]NAutologous serum–Y [89]Y [89]A preliminary study on 32 patients (4–15 years old) [89]Centrifuge peripheral venous blood at 1500–2000 g for 10 min to separate the serum and then topically administeredIntra and post 8 and 24 hContributed to tonsillar fossa epithelizatio...…”

Section: Main Text: Topical Biomaterials Used For Pthmentioning

confidence: 99%

Topical biomaterials to prevent post-tonsillectomy hemorrhage

Liu

Rodman

Worobetz

et al. 2019

Journal of Otolaryngology - Head & Neck Surgery

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Despite advances in surgical technique, postoperative hemorrhage remains a common cause of mortality and morbidity for patients following tonsillectomy. Application of biomaterials at the time of tonsillectomy can potentially accelerate mucosal wound healing and eliminate the risk of post-tonsillectomy hemorrhage (PTH). To understand the current state and identify possible routes for the development of the ideal biomaterials to prevent PTH, topical biomaterials for eliminating the risk of PTH were reviewed. Alternative topical biomaterials that hold the potential to reduce the risk of PTH were also summarized.

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Does topical use of autologous serum help to reduce post-tonsillectomy morbidity? A prospective, controlled preliminary study

Abstract: In tonsillectomy patients, topically administered autologous serum contributed to throat pain relief and tonsillar fossa epithelisation during the post-operative period.

Cited by 9 publications

References 26 publications

Is Ginger Effective in Reducing Post-tonsillectomy Morbidity? A Prospective Randomised Clinical Trial

Is Ginger Effective in Reducing Post-tonsillectomy Morbidity? A Prospective Randomised Clinical Trial

Beneficial effects of dexmedetomidine on early postoperative cognitive dysfunction in pediatric patients with tonsillectomy

Topical biomaterials to prevent post-tonsillectomy hemorrhage

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