title: Control of bleeding by silk ligation and diathermy coagulation during tonsillectomy: A comparison of efficacy of the two techniques in the first 24 hours after surgery.
abstract: OBJECTIVE
  To assess and compare the relative efficacy of silk ligation and diathermy coagulation techniques in controlling bleeding during tonsillectomy in the first 24 hours.
  
  
  METHODS
  This prospective study was conducted at the Department of ENT, Khalifa Gul Nawaz Teaching Hospital, Bannu and this department related consultants' private clinics from January 1, 2012 to December 31, 2014. The study included 180 cases. All patients included were having history of recurrent, acute tonsillitis, with more than 6-7 episodes in one year, five episodes per year for two years, or three episodes per year for three years. All the surgeries were performed by dissection method. Haemostasis during the procedure was secured by either ligation with silk 1 or using diathermy. The results were analyzed using SPSS 16.0 for windows.
  
  
  RESULTS
  A total of180 cases were included in the study. The ages of the patients ranged from 5 to 40 years with the mean age of 15.56 years and a std.deviation of +/- 8.24. The male to female ratio was 1.25:1. The number of hemorrhages occurring was greater in the 'diathermy coagulation' group as compared to the 'silk ligation' group. However, the observed difference was statistically insignificant (p >.05).
  
  
  CONCLUSIONS
  Primary haemorrhage occurring during tonsillectomy is a serious threat and control of bleeding during the procedure should therefore be meticulous. Both suture ligation and coagulation diathermy for control of bleeders during the procedure by dissection method are equally effective.
authors.affiliation: Khurshid Anwar, Senior Registrar, Department of ENT and Head & Neck Surgery, Hayatabad Medical complex, Peshawar, Pakistan.
authors.forename: Khurshid
authors.initials: K
authors.lastname: Anwar
authors.affiliation: Rafiq Ahmad, Associate Professor, Department of ENT and Head & Neck Surgery, Khalifa Gul Nawaz Teaching Hospital Bannu, Pakistan.
authors.forename: Rafiq
authors.initials: R
authors.lastname: Ahmad
authors.affiliation: Muneeb Khan, Trainee Medical Officer, Dept. of ENT and Head & Neck Surgery, PGMI HMC, Peshawar, Pakistan.
authors.forename: Muneeb
authors.initials: M
authors.lastname: Khan
keywords: Diathermy; Haemostasis; Primary haemorrhage; Suture Ligation; Tonsillectomy