A prospective study of factors which may predispose to post-operative tonsillar fossa haemorrhage.

Adeno-tonsillectomy and tonsillectomy are frequently performed and haemorrhage remains an important post-operative complication. A prospective study of 1090 patients undergoing surgery over a 12-month period was undertaken investigating whether the following factors influenced post-operative haemorrhage: age and sex of patients, method of tonsillectomy, haemostasis and premedication, month of operation and experience of surgeon. A significantly higher incidence of post-operative haemorrhage occurred in the group aged 16-25 years and significantly more males suffered post-operative haemorrhage. This haemorrhage more frequently occurred in the warmer months of May to July. Guillotine tonsillectomy was found to be as effective as dissection and no higher incidence of post-operative haemorrhage was recorded. Method of haemostasis, surgical experience and premedication did not influence the outcome. We conclude that the guillotine used in controlled circumstances is as safe as dissection.