Faramarzi Mohammad, Shishegar Mahmood, Kazemi Tayebeh, Tavakolpour Saleh Hamid, Roosta Sareh
Department of Otolaryngology Head and Neck Surgery, Otolaryngology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Eur Arch Otorhinolaryngol. 2021 Feb;278(2):485-492. doi: 10.1007/s00405-020-06173-7. Epub 2020 Jun 29.
Pain and hemorrhage are common morbidities after tonsillectomy. Although many studies have focused on post-tonsillectomy pain, inadequate researches are available on wound healing. Hence, there is a definite need for a novel technique to facilitate the healing process and thereby improving the post-tonsillectomy recovery.
This prospective and randomized study was conducted on 60 adult patients who underwent tonsillectomy. They were divided into two groups of control and amniotic membrane (AM). Human amniotic membrane was applied over the tonsillar bed as a biologic dressing. Post-tonsillectomy pain and bleeding were evaluated. Also, the healing rate was assessed on days 5, 10 and 15 post-operatively.
The pain score in the AM group was lower than that in the control group during the first week after surgery (P < 0.0001). Moreover, the AM group returned faster to their normal diet in comparison with the control group (P < 0.0001). With respect to the healing rate, there were no significant differences between the groups on day 5 (P > 0.05), whereas a significant difference was seen on days 10 and 15 post-surgery (P < 0.0001). There was no significant difference between the two groups in terms of post-operative bleeding (P ≅ 1).
We observed that the use of AM graft as a biologic dressing might be beneficial in reducing post-operative pain and promoting the wound healing process. The results represent a further step toward developing a new technique for coverage of tonsillar fossa with sheeting or wearing grafts.
疼痛和出血是扁桃体切除术后常见的并发症。尽管许多研究都聚焦于扁桃体切除术后的疼痛,但关于伤口愈合的研究却不足。因此,迫切需要一种新技术来促进愈合过程,从而改善扁桃体切除术后的恢复情况。
本前瞻性随机研究对60例接受扁桃体切除术的成年患者进行。他们被分为对照组和羊膜(AM)组。将人羊膜作为生物敷料应用于扁桃体床。评估扁桃体切除术后的疼痛和出血情况。此外,在术后第5天、第10天和第15天评估愈合率。
术后第一周,AM组的疼痛评分低于对照组(P < 0.0001)。此外,与对照组相比,AM组恢复正常饮食的速度更快(P < 0.0001)。关于愈合率,术后第5天两组之间无显著差异(P > 0.05),而术后第10天和第15天有显著差异(P < 0.0001)。两组术后出血情况无显著差异(P ≅ 1)。
我们观察到,使用AM移植物作为生物敷料可能有助于减轻术后疼痛并促进伤口愈合过程。这些结果代表了朝着开发一种用薄片或穿戴移植物覆盖扁桃体窝的新技术迈出的又一步。