title: Intraoperative Use of QuikClot During Adenotonsillectomy: A Prospective Pediatric Trial.
abstract: BACKGROUND
  Achieving hemostatic control after intracapsular adenotonsillectomy with minimal cauterization may potentially lead to improved outcomes with respect to return to normal diet, normal activity, and less use of narcotic pain medications.
  
  
  METHODS
  A prospective, nonrandomized, consecutive series of children with obstructive tonsils and adenoids at a tertiary children's hospital was undertaken.
  
  
  RESULTS
  One hundred consecutive children (52 boys/48 girls) ages 0-16 (mean=4.8, SD=3.7, median=4.0) years were recruited with complete data available on all 100. Mean total procedure time was 19.8 (SD=4.3, median=19.5) minutes, including mean total cauterization time of 155.3 (SD=59.7 seconds, median=143.0) (adenoids: mean=60.9, SD=31.5, median=53.0; tonsils: mean=94.5, SD=41.9, median=82.0) minutes. Mean estimated blood loss was 29.4 (SD=40.9, median=25.0) ml. There were no major complications (0/100 episodes of bleeding or dehydration after surgery). Mean return to normal diet was 3.4 (SD=2.2, median=3.0) days; mean return to normal activity was 2.8 (SD=2.1, median=3.0) days, and mean days to no further narcotics was 3.0 (SD=2.3, median=2.0) days. Mean days to complete recovery (normal diet, normal activity, and no narcotics) was 4.5 (SD=2.1, median=4.0, range: 1-10). Total cautery time was significantly correlated with time to complete recovery (P<.05).
  
  
  CONCLUSIONS
  Intracapsular microdebrider tonsillectomy with adenoidectomy utilizing QuikClot to enhance the hemostasis results in recovery times better than previously reported for this common operation in children.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Children's Hospital of the King's Daughters, Norfolk, Virginia, USA Craig.derkay@chkd.org.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Derkay
authors.affiliation: Department of Distance Learning, Eastern Virginia Medical School, Norfolk, Virginia, USA.
authors.forename: Hind A
authors.initials: HA
authors.lastname: Baydoun
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Stone
mesh_terms: D000233:Adenoidectomy; D000293:Adolescent; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006490:Hemostatics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D014068:Tonsillectomy
chemical_list: D006490:Hemostatics
keywords: adenoiditis; clinical trials; experimental; otolaryngology; otology; pediatric; rhinology