title: Diathermy power settings as a risk factor for hemorrhage after tonsillectomy.
abstract: OBJECTIVE
  To investigate bipolar diathermy power settings as a risk factor for postoperative hemorrhage following tonsillectomy.
  
  
  METHODS
  A prospective cohort study was undertaken between July 2003 and September 2004 in National Health Service (NHS) and independent hospitals in England and Northern Ireland. Data were collected on patient characteristics, tonsillectomy technique, and postoperative hemorrhage within 28 days of surgery.
  
  
  RESULTS
  Among the 9572 patients who had a tonsillectomy performed with bipolar diathermy dissection and hemostasis, the overall rate of hemorrhage was 4.6 percent and the risk of hemorrhage was not associated with the diathermy power setting. Among the 8465 patients who had tonsillectomy with cold steel dissection and bipolar diathermy hemostasis, the rate of hemorrhage increased from 1.8% in patients with the lowest power settings (6 to 8 watts) to 3.7% in those with settings above 18 watts (P value for trend = 0.005).
  
  
  CONCLUSIONS
  In tonsillectomies using cold steel dissection and bipolar diathermy for hemostasis, the risk of postoperative hemorrhage becomes greater as diathermy power increases.
authors.affiliation: Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, England, UK.
authors.forename: David
authors.initials: D
authors.lastname: Lowe
authors.forename: David A
authors.initials: DA
authors.lastname: Cromwell
authors.forename: James D
authors.initials: JD
authors.lastname: Lewsey
authors.forename: Lynn P
authors.initials: LP
authors.lastname: Copley
authors.forename: Peter
authors.initials: P
authors.lastname: Brown
authors.forename: Matthew
authors.initials: M
authors.lastname: Yung
authors.forename: Jan H
authors.initials: JH
authors.lastname: van der Meulen
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003972:Diathermy / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D014068:Tonsillectomy / Q000009:adverse effects / Q000379:methods*