title: Intraoperative use of FloSeal with adenotonsillectomy to prevent adverse postoperative outcomes in pediatric patients.
abstract: OBJECTIVE
  The purpose of this study was to compare postoperative complications associated with monopolar dissection adenotonsillectomy, with and without the application of FloSeal at the completion of the procedure.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Tertiary care pediatric hospital.
  
  
  METHODS
  This was a retrospective cohort study of 800 cases of adenotonsillectomy. Two cohorts of patients were identified based on whether or not FloSeal was used intraoperatively during the completion of the monopolar dissection adenotonsillectomy. Outcomes that were measured included: (1) age, (2) sex, (3) diagnosis, (4) primary hemorrhage, (5) secondary hemorrhage, (6) return to operating room, and (7) dehydration. All binomial outcomes measured were subjected to chi-square and t tests.
  
  
  RESULTS
  Age and gender were similar between the 2 groups. Chronic tonsillitis was the primary indication more often in the control group; this was statistically significant. Primary hemorrhage occurred in 1 subject from each group (0.28%); secondary hemorrhage occurred in 11 subjects from the FloSeal group (3.22%) and 7 from the control group (1.87%). Both outcomes were not statistically different between the 2 groups. Return to operating room showed no statistically significant difference between groups. The need for postoperative admission for dehydration failed to show statistical significance between groups.
  
  
  CONCLUSIONS
  In our experience, the application of FloSeal hemostatic matrix after monopolar adenotonsillectomy demonstrates no additional reduction in postoperative adverse events encountered in the pediatric population. Specifically, our data failed to demonstrate statistically significant reduction of: (1) primary hemorrhage, (2) secondary hemorrhage, (3) return to operating theatre, or (4) dehydration.
authors.affiliation: Michigan State University, Detroit Medical Center, Detroit, Michigan, USA. stevenrdyer@gmail.com
authors.forename: Steven R
authors.initials: SR
authors.lastname: Dyer
authors.forename: Samba
authors.initials: S
authors.lastname: Bathula
authors.forename: Phani
authors.initials: P
authors.lastname: Durvasula
authors.forename: David
authors.initials: D
authors.lastname: Madgy
authors.forename: Michael
authors.initials: M
authors.lastname: Haupert
authors.forename: James
authors.initials: J
authors.lastname: Dworkin
authors.forename: Saidshoib
authors.initials: S
authors.lastname: Sana
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects / Q000379:methods*; D000293:Adolescent; D017115:Catheter Ablation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage*; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D007223:Infant; D007432:Intraoperative Period; D008297:Male; D008824:Michigan / Q000453:epidemiology; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D014068:Tonsillectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
chemical_list: C411004:FloSeal Matrix; D006490:Hemostatics
keywords: FloSeal; adenoidectomy; adenotonsillectomy; monopolar cautery; pediatric otolaryngology; postoperative bleeding; postoperative complications