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Wound healing after tonsillectomy – a review of the literature

Published online by Cambridge University Press:  05 October 2018

N H Davidoss*
Affiliation:
Department of Otolaryngology, Head, Neck and Skull Base Surgery, Sir Charles Gairdner Hospital, Nedlands, Australia Ear Sciences Centre, School of Medicine, University of Western Australia, Perth, Australia Ear Science Institute of Australia, Perth, Australia
R Eikelboom
Affiliation:
Ear Sciences Centre, School of Medicine, University of Western Australia, Perth, Australia Ear Science Institute of Australia, Perth, Australia Department of Speech and Language Pathology and Audiology, University of Pretoria, South Africa
P L Friedland
Affiliation:
Department of Otolaryngology, Head, Neck and Skull Base Surgery, Sir Charles Gairdner Hospital, Nedlands, Australia Ear Sciences Centre, School of Medicine, University of Western Australia, Perth, Australia Ear Science Institute of Australia, Perth, Australia School of Medicine, University of Notre Dame, Fremantle, Australia
P L Santa Maria
Affiliation:
Department of Otolaryngology, Head, Neck and Skull Base Surgery, Sir Charles Gairdner Hospital, Nedlands, Australia Ear Sciences Centre, School of Medicine, University of Western Australia, Perth, Australia Ear Science Institute of Australia, Perth, Australia Department of Otolaryngology, Head and Neck Surgery, Stanford University, California, USA
*
Author for correspondence: Dr Nishant Hemanth Davidoss, Department of Otolaryngology, Head, Neck and Skull Base Surgery, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia E-mail: [email protected] Fax: +61 8 9346 4899

Abstract

Objective

To summarise the available literature related to wound healing post tonsillectomy, including the stages of healing, experimental models for assessing healing (in animals and humans) and the various factors that affect wound healing.

Methods

A search of the English literature was conducted using the Ovid Medline database, with the search terms ‘tonsillectomy’ or ‘tonsil’ and ‘wound healing’. Thirty-one articles that objectively assessed tonsillectomy wound healing were included for analysis.

Results

The majority of assessments in humans investigating tonsillectomy wound healing involve serial direct clinical examinations of the oral cavity. Many patient and surgical factors have been shown to affect wound healing after tonsillectomy. There is some research to suggest that the administration of adjunctive treatment in the post-operative period may be beneficial to tonsillectomy wound healing.

Conclusion

Wound healing post tonsillectomy has been poorly researched. Having a better understanding of the process of wound healing would allow surgeons to potentially prevent, anticipate and manage complications from the surgery that arise as part of the healing process.

Type
Review Articles
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr N H Davidoss takes responsibility for the integrity of the content of the paper

References

1Cullen, KA, Hall, MJ, Golosinskiy, A. Ambulatory surgery in the United States, 2006. Natl Health Stat Report 2009;(11):125Google Scholar
2Curtis, JL, Harvey, DB, Willie, S, Narasimhan, E, Andrews, S, Henrichsen, J et al. Causes and costs for ED visits after pediatric adenotonsillectomy. Otolaryngol Head Neck Surg 2015;152:691–6Google Scholar
3Moher, D, Liberati, A, Tetzlaff, J, Altman, DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 2009;62:1006–12Google Scholar
4Isaacson, G. Pediatric tonsillectomy: an evidence-based approach. Otolaryngol Clin North Am 2014;47:673–90Google Scholar
5Kataura, A, Doi, Y, Narimatsu, E. Histological research concerning cryotonsillectomy in dogs. Arch Otorhinolaryngol 1975;209:3345Google Scholar
6Johnson, K, Vaughan, A, Derkay, C, Welch, JC, Werner, A, Kuhn, MA et al. Microdebrider vs electrocautery: a comparison of tonsillar wound healing histopathology in a canine model. Otolaryngol Head Neck Surg 2008;138:486–91Google Scholar
7Park, SK, Kim, J, Kim, JM, Yeon, JY, Shim, WS, Lee, DW. Effects of oral prednisolone on recovery after tonsillectomy. Laryngoscope 2015;125:111–17Google Scholar
8Kara, M, Erdogan, H, Altinisik, HB, Aylanc, H, Guclu, O, Derekoy, FS. Does topical use of autologous serum help to reduce post-tonsillectomy morbidity? A prospective, controlled preliminary study. J Laryngol Otol 2016;130:662–8Google Scholar
9Sadikoglu, F, Kurtaran, H, Ark, N, Ugur, KS, Yilmaz, T, Gozdemir, M et al. Comparing the effectiveness of “plasma knife” tonsillectomy with two well-established tonsillectomy techniques: cold dissection and bipolar electrocautery. A prospective randomized study. Int J Pediatr Otorhinolaryngol 2009;73:1195–8Google Scholar
10Stavroulaki, P, Skoulakis, C, Theos, E, Kokalis, N, Valagianis, D. Thermal welding versus cold dissection tonsillectomy: a prospective, randomized, single-blind study in adult patients. Ann Otol Rhinol Laryngol 2007;116:565–70Google Scholar
11Noordzij, JP, Affleck, BD. Coblation versus unipolar electrocautery tonsillectomy: a prospective, randomized, single-blind study in adult patients. Laryngoscope 2006;116:1303–9Google Scholar
12Temple, RH, Timms, MS. Paediatric coblation tonsillectomy. Int J Pediatr Otorhinolaryngol 2001;61:195–8Google Scholar
13Sharp, JF, Rogers, MJ, Riad, M, Kerr, AI. Combined study to assess the role of calcium alginate swabs and ligation of the inferior tonsillar pole in the control of intra-operative blood loss during tonsillectomy. J Laryngol Otol 1991;105:191–4Google Scholar
14Anderson, HA, Rice, BJ, Cantrell, RW. Effects of injected deposteroid on posttonsillectomy morbidity: a double-blind study. Arch Otolaryngol 1975;101:86–8Google Scholar
15Freeman, SB, Markwell, JK. Sucralfate in alleviating post-tonsillectomy pain. Laryngoscope 1992;102:1242–6Google Scholar
16Ozcan, M, Altuntas, A, Unal, A, Nalca, Y, Aslan, A. Sucralfate for posttonsillectomy analgesia. Otolaryngol Head Neck Surg 1998;119:700–4Google Scholar
17Vaiman, M, Eviatar, E, Shlamkovich, N, Segal, S. Effect of modern fibrin glue on bleeding after tonsillectomy and adenoidectomy. Ann Otol Rhinol Laryngol 2003;112:410–14Google Scholar
18Celebi, S, Tepe, C, Yelken, K, Celik, O. Efficacy of dexpanthenol for pediatric post-tonsillectomy pain and wound healing. Ann Otol Rhinol Laryngol 2013;122:464–7Google Scholar
19Tepe, Karaca C, Celebi, S, Oysu, C, Celik, O. Does cooling the tonsillar fossae during thermal welding tonsillectomy have an effect on postoperative pain and healing? Eur Arch Otorhinolaryngol 2013;270:363–6Google Scholar
20Ragab, SM. Six years of evidence-based adult dissection tonsillectomy with ultrasonic scalpel, bipolar electrocautery, bipolar radiofrequency or ‘cold steel’ dissection. J Laryngol Otol 2012;126:1056–62Google Scholar
21Mozet, C, Prettin, C, Dietze, M, Fickweiler, U, Dietz, A. Use of Floseal and effects on wound healing and pain in adults undergoing tonsillectomy: randomised comparison versus electrocautery. Eur Arch Otorhinolaryngol 2012;269:2247–54Google Scholar
22Hahn, CH, Rungby, JA, Overgaard, T, Moller, H, Schultz, P, Tos, M. Effect of diathermy on pain and healing in tonsillectomy, compared with other methods of haemostasis: a randomised study. J Laryngol Otol 2009;123:648–55Google Scholar
23Akbas, Y, Pata, YS, Unal, M, Gorur, K, Micozkadioglu, D. The effect of fusafungine on post-operative pain and wound healing after pediatric tonsillectomy. Int J Pediatr Otorhinolaryngol 2004;68:1023–6Google Scholar
24Cook, JA, Murrant, NJ, Evans, KL, Lavelle, RJ. A randomized comparison of three post-tonsillectomy diets. Clin Otolaryngol Allied Sci 1992;17:2831Google Scholar
25Aydin, S, Taskin, U, Altas, B, Erdil, M, Senturk, T, Celebi, S et al. Post-tonsillectomy morbidities: randomised, prospective controlled clinical trial of cold dissection versus thermal welding tonsillectomy. J Laryngol Otol 2014;128:163–5Google Scholar
26Hanci, D, Altun, H. Effectiveness of hyaluronic acid in post-tonsillectomy pain relief and wound healing: a prospective, double-blind, controlled clinical study. Int J Pediatr Otorhinolaryngol 2015;79:1388–92Google Scholar
27Aksoy, F, Ozturan, O, Veyseller, B, Yildirim, YS, Demirhan, H. Comparison of radiofrequency and monopolar electrocautery tonsillectomy. J Laryngol Otol 2010;124:180–4Google Scholar
28Orlowski, K, Lisowska, G, Misiolek, H, Paluch, Z, Misiolek, M. The efficacy of perioperative antibiotic therapy in tonsillectomy patients. Adv Clin Exp Med 2016;25:493503Google Scholar
29Windfuhr, JP, Sack, F, Sesterhenn, AM, Landis, BN, Chen, YS. Post-tonsillectomy taste disorders. Eur Arch Otorhinolaryngol 2010;267:289–93Google Scholar
30Auf, I, Osborne, JE, Sparkes, C, Khalil, H. Is the KTP laser effective in tonsillectomy? Clin Otolaryngol Allied Sci 1997;22:145–6Google Scholar
31Magdy, EA, Elwany, S, el-Daly, AS, Abdel-Hadi, M, Morshedy, MA. Coblation tonsillectomy: a prospective, double-blind, randomised, clinical and histopathological comparison with dissection-ligation, monopolar electrocautery and laser tonsillectomies. J Laryngol Otol 2008;122:282–90Google Scholar
32Elwany, S, Nour, YA, Magdy, EA. Does laryngopharyngeal reflux affect healing and recovery after tonsillectomy? J Laryngol Otol 2008;122:603–8Google Scholar
33Mat, Lazim N, Abdullah, B, Salim, R. The effect of Tualang honey in enhancing post tonsillectomy healing process. An open labelled prospective clinical trial. Int J Pediatr Otorhinolaryngol 2013;77:457–61Google Scholar
34Isaacson, G. Tonsillectomy healing. Ann Otol Rhinol Laryngol 2012;121:645–9Google Scholar
35Heywood, RL, Khalil, HM, Kothari, S, Chawda, S, Kotecha, BT. Radiological airway changes following bipolar radiofrequency volumetric tissue reduction. J Laryngol Otol 2010;124:1078–84Google Scholar
36Isaacson, G. Tonsillectomy care for the pediatrician. Pediatrics 2012;130:324–34Google Scholar
37Cohen, N, Sommer, DD. Post-tonsillectomy pain control: consensus or controversy? Pain Manag 2016;6:31–7Google Scholar
38Couto, EV, Ballin, CR, Sampaio, CP, Maeda, CA, Ballin, CH, Dassi, CS et al. Experimental study on the effects of bismuth subgallate on the inflammatory process and angiogenesis of the oral mucosa. Braz J Otorhinolaryngol 2016;82:1725Google Scholar
39Sinha, UK, Gallagher, LA. Effects of steel scalpel, ultrasonic scalpel, CO2 laser, and monopolar and bipolar electrosurgery on wound healing in guinea pig oral mucosa. Laryngoscope 2003;113:228–36Google Scholar
40Liboon, J, Funkhouser, W, Terris, DJ. A comparison of mucosal incisions made by scalpel, CO2 laser, electrocautery, and constant-voltage electrocautery. Otolaryngol Head Neck Surg 1997;116:379–85Google Scholar
41Tobey, NA, Hosseini, SS, Caymaz-Bor, C, Wyatt, HR, Orlando, GS, Orlando, RC. The role of pepsin in acid injury to esophageal epithelium. Am J Gastroenterol 2001;96:3062–70Google Scholar
42Siupsinskiene, N, Zekoniene, J, Padervinskis, E, Zekonis, G, Vaitkus, S. Efficacy of sucralfate for the treatment of post-tonsillectomy symptoms. Eur Arch Otorhinolaryngol 2015;272:271–8Google Scholar
43Tonks, A, Cooper, RA, Price, AJ, Molan, PC, Jones, KP. Stimulation of TNF-alpha release in monocytes by honey. Cytokine 2001;14:240–2Google Scholar