title: A completed audit cycle on post-tonsillectomy haemorrhage rate: coblation versus standard tonsillectomy.
abstract: CONCLUSIONS
  A significant reduction in post-tonsillectomy secondary haemorrhage rate was observed after coblation tonsillectomy was abandoned in our department.
  
  
  OBJECTIVE
  Comparison of the postoperative haemorrhage rate following coblation tonsillectomy and routine dissection tonsillectomy.
  
  
  METHODS
  This was a retrospective study. In the first audit period, 441 sequential tonsillectomies between January and September 2002 were reviewed. Coblation was compared with cold steel and diathermy dissection with either ties and/or diathermy used for haemostasis. Coblation tonsillectomy was subsequently abandoned in our unit and, in the second audit period, all tonsillectomies (n=416) between July 2003 and August 2004 were included. Statistical analysis was performed using the chi2 test.
  
  
  RESULTS
  The overall primary haemorrhage rate in the first audit cycle was 1.8% (8/441). In the second cycle with no coblation procedures, 1.4% of patients (6/416) suffered from primary haemorrhage (c.f. 8/441 (1.8%) in the first cycle, p=0.666). Secondary haemorrhage, was seen among 15.4% of patients (68/441) in the first audit cycle. In the second cycle, after coblation was discontinued, the secondary haemorrhage rate fell significantly (p<0.001) to 5.8% (24/416). A breakdown of the results of cold steel/diathermy and coblation techniques in both adults and children is also presented.
authors.affiliation: Department of Otorhinolaryngology, Derbyshire Royal Infirmary, UK.
authors.forename: F
authors.initials: F
authors.lastname: Javed
authors.forename: M
authors.initials: M
authors.lastname: Sadri
authors.forename: J
authors.initials: J
authors.lastname: Uddin
authors.forename: S
authors.initials: S
authors.lastname: Mortimore
authors.forename: D
authors.initials: D
authors.lastname: Parker
mesh_terms: D000328:Adult; D002648:Child; D003452:Cryosurgery / Q000379:methods; D004564:Electrocoagulation / Q000379:methods; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008485:Medical Audit; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D012189:Retrospective Studies; D014068:Tonsillectomy / Q000379:methods*