Abstract

Aim: To determine the ‘true’ secondary haemorrhage rate post-tonsillectomy.

Methods: A telephone survey was conducted of 127 consecutive patients who had a tonsillectomy at the Freeman Hospital over a two-month period.

Results: 99 patients were contactable. There were 38 post-tonsillectomy bleeds, 23 of which were minor and 15 significant. 23 bleeds went unreported and four of these were significant. 11 percent of bleeds post-cold steel tonsillectomy were significant, compared to 28 percent of bleeds post-diathermy dissection.

Conclusion: There is a high incidence of unreported bleeding (61 percent of those that bled) and a third of adults who suffered a significant bleed did not report it. Diathermy had a significantly higher proportion of significant bleeds compared to cold steel. It is recommended if secondary haemorrhage rates are reported in the literature then small studies should contact patients for ‘true’ secondary bleed rates while large studies should use return to theatre and need for transfusion rates.