Minimising haemorrhage and promoting healing of raw areas are cornerstones for uneventful and speedy recovery after tonsillectomy. In this single-blinded prospective experimental study, application of platelet-rich plasma to one side tonsillar bed has been compared to the other side in the same patient in terms of haemorrhage and pain in the 36 hours after tonsillectomy. The study is based on the concept that platelet-rich plasma works as a tissue sealant and promotes healing through function of growth factors which attract undifferentiated cells in the newly formed matrix and trigger cell division. Inflammation is limited and epithelialisation is accelerated. This application also has some antimicrobial activity. The platelet-rich plasma was prepared from the patient’s own blood in the department of immunohaematology and blood transfusion the day before surgery.

After tonsillectomy, the platelet-rich plasma was applied to one tonsillar bed in 36 patients. A VAS was used for pain assessment at two, four and six hours on the first day and three times the next day. Haemorrhage was graded from nil to fatal bleeding in five stages. A statistically significant improvement in pain scores and haemorrhage was noted on the side to which platelet-rich plasma was applied.

The method of tonsillectomy appears to be identical in all cases and so does the surgical skill level. The cost is low but does require inter-departmental involvement for a simple procedure.

Haemostasis and analgesia with autologous platelet-rich plasma in tonsillectomy.
Chettri MN, Jayagandhi SK, Konyak Y, et al.
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Madhup K Chaurasia

Mid and South Essex NHS Foundation Trust, UK.

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