Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-03T08:43:16.228Z Has data issue: false hasContentIssue false

Bismuth subgallate – its role in tonsillectomy

Published online by Cambridge University Press:  29 June 2007

J. E. Fenton
Affiliation:
Department of Otolaryngology, Temple Street Children's Hospital, Dublin.
A. W. Blayney
Affiliation:
Department of Otolaryngology, Temple Street Children's Hospital, Dublin.
T. P. O'Dwyer*
Affiliation:
Department of Otolaryngology, Temple Street Children's Hospital, Dublin.
*
Address for correspondence: Mr T. P. O'Dwyer Department of Otolaryngology, Temple Street Children's Hospital, Dublin 1, Ireland.

Abstract

There have been many attempts at identifying substances and describing methods that would assist the surgeon and be of benefit to the patient undergoing a tonsillectomy. The use of bismuth subgallate as a haemostatic adjunct during tonsillectomy has only been described previously in retrospective studies. A controlled prospective randomized trial of 100 paediatric patients, in which 50 patients had a tonsillectomy performed using bismuth subgallate as a haemostatic agent and in which the remainder did not have any associated haemostatic substance, is presented here.

Data on 72 patients was analysed, 39 patients belonging to the bismuth subgallate group and the remaining 33 to the control group. The time for haemostasis was three to 18 (mean 7.8) minutes in the bismuth group. It was four to 16 (mean 9.9) minutes in the non-bismuth group. These figures are statistically significant.

The range of ties used in the bismuth group was none to three (mean 1.5) ties and one to seven (mean 3.4) ties in the non-bismuth group. These figures are also statistically significant. The remainder of the recorded parameters did not differ significantly.

It was found that bismuth subgallate/adrenaline paste decreases operating time by significantly reducing the haemostasis time and the number of ties required but does not decrease post-operative morbidity.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the Otorhinolaryngology Research Society, Autumn Meeting, London, October 1993.

References

Cozzi, L. M., Megerian, C. A., Dugue, C., Barcello, M., Abdul-Karim, F. W., Arnold, J. E., Maniglia, A. J. (1991) Pulmonary sequelae of intraparenchymal bismuth subgallate. Laryngoscope 102(6): 597599.CrossRefGoogle Scholar
Linden, B. E., Gross, C. W., Long, T. E., Laxar, R. H. (1990) Morbidity in pediatric tonsillectomy. Laryngoscope 100: 120124.CrossRefGoogle ScholarPubMed
Maniglia, A. J., Kushner, H., Cozzi, L. (1989) Adenotonsillectomy: a safe outpatient procedure. Archives of Otolaiyngology Head and Neck Surgery 115: 9294.CrossRefGoogle ScholarPubMed
Phillips, J. J., Thornton, A. R. D. (1989) Tonsillectomy haemostasis: diathermy or ligation. Clinical Otolaryngology 14: 419424.CrossRefGoogle Scholar
Sharp, J. F., Rogers, M. J. C., Riad, M., Kerr, A. I. G. (1991) Combined study to assess the role of calcium alginate swabs and ligation of the inferior tonsillar pole in the control of intraoperative blood loss during tonsillectomy. Journal of Laryngology and Otology 105: 191194.CrossRefGoogle ScholarPubMed
Tannous, W. N., Azouz, E. M., Tewfik, T. L. (1989) Pitfall to avoid pharyngeal opacities caused by bismuth subgallate. Canadian Association of Radiologists Journal 40(6): 312.Google ScholarPubMed
Thorisdottir, H., Ratnoff, O. D., Maniglia, A. J. (1988) Activation of Haemann factor (factor XII) by bismuth subgallate, a haemostatic agent. Journal of Laboratoiy and Clinical Medicine 112: 481486.Google Scholar
Weimert, T. A., Babyak, J. W., Richter, H. J. (1990) Electrodissection tonsillectomy. Archives of Orolarvngologv Head and Neck Surgery 116: 186188.CrossRefGoogle ScholarPubMed