Metrics details. 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.
Tonsillectomy is among the most common surgeries performed in pediatric patients. Over , children under the age of 15 undergo tonsillectomy annually in the United States [ 1 , 2 , 3 ]. Following surgical removal of the tonsils, the surgical site s tonsillar fossae heal secondarily. One of the most common complications following tonsillectomy is hemorrhage from the tonsillar fossae, called post-tonsillectomy hemorrhage PTH [ 4 ].
PTH rates 2. Post-tonsillectomy hemorrhage often requires hospital readmission, surgical intervention, and can even result in significant morbidity such as shock, airway obstruction and need for blood transfusion [ 6 ]. The hemorrhage is generally unexpected and unpredictable [ 7 , 8 , 9 , 10 , 11 , 12 ], and resuscitation with life-threatening PTH can prove especially challenging [ 13 , 14 ].
Attempts to reduce the morbidity of tonsillectomy have included changes to the surgical approach and peri-operative medications to reduce the risk of bleeding. Technical modifications to the procedure, such as partial or intracapsular tonsillectomy, can reduce pain and PTH [ 15 , 16 , 17 ]. However, such modifications are not indicated for chronic infection and can result in tissue regrowth, requiring revision surgery [ 18 , 19 ]. A low cost, easily applied, effective strategy to prevent PTH remains elusive.
