title: Dissection and hemostasis with hydroxilated polyvinyl acetal tampons in open thyroid surgery.
abstract: BACKGROUND
  The essential objectives for thyroidectomy are: avoidance of injury to the recurrent laryngeal nerves, conservation of the parathyroid glands, an accurate haemostasis and an excellent cosmesis. In the last 10 years major improvements and new technologies have been proposed and applied in thyroid surgery; among these mini-invasive thyroidectomy, regional anaesthesia and intraoperative neuromonitoring, and new devices for achieving dissection and haemostasis. Minor bleeding from small vessels could be a major complication in thyroid surgery. The purpose of ligating vessels is to maintain the surgical site free from an excess of blood and reduce blood loss in the patient.
  
  
  METHODS
  Hydroxylated polyvinyl acetal tampons (HPA) are made by a synthetic, open cell foam structure able to absorb fluids up to 25 times the initial weight. We tested their efficacy for small bleeding control and tissue dissection during several thyroid procedures.
  
  
  RESULTS
  HPA tampons have been found extremely useful to absorb blood coming from minor and diffuse loss, helping to control bleeding by a combined action of fluid absorption and local compression. The porous design of the tampon allows the use of the suction device right through the tampon itself. Thanks to the initial mildly hard consistency, we also used HPA tampons as dissecting instruments.
  
  
  CONCLUSIONS
  In our experience the use of HPA tampons resulted extremely efficient for minor bleeding control, fluids removal and tissue dissection during thyroid surgery.
authors.affiliation: Department of Surgical Sciences, University of Insubria, Viale Borri 57, 21100 Varese, Italy. gianlorenzo.dionigi@uninsubria.it
authors.forename: Gianlorenzo
authors.initials: G
authors.lastname: Dionigi
authors.forename: Luigi
authors.initials: L
authors.lastname: Boni
authors.forename: Francesca
authors.initials: F
authors.lastname: Rovera
authors.forename: Renzo
authors.initials: R
authors.lastname: Dionigi