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Published in: European Archives of Oto-Rhino-Laryngology 7/2019

01-07-2019 | Seroma | Head & Neck

Drain-free parotidectomy: a pilot study using ARTISS fibrin sealant

Authors: H. A. Cunniffe, B. L. K. Wong, A. W. Hilger, O. T. Burgan

Published in: European Archives of Oto-Rhino-Laryngology | Issue 7/2019

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Abstract

Purpose

Parotidectomy is the definitive procedure for diagnosis and treatment of most parotid masses but, due to the risk of haematoma and seroma formation, has traditionally included a drain. The drain itself comes with its own risks and, in most hospitals, the need for overnight admission, which has significant cost implications (Mallon et al. Ann R Coll Surg Engl 95(4):258–262; 2013). Fibrin glue, with its haemostatic and adhesive properties, reduces the risk of collection or haematoma and therefore may negate the need for a drain. This is the first study to look at the use of ARTISS as an alternative to drains in parotidectomy.

Methods

We performed a retrospective study of all the patients who underwent a partial parotidectomy over a 4-year period from 2014 until 2018 under the same senior surgeon. Patients were divided into those that had a drain and those that had ARTISS. Their operative record, inpatient notes and clinic letters were reviewed to record information regarding length of stay, histology, complications and recurrence.

Results

A total of 34 patients were identified; 17 ARTISS and 17 drain patients. We showed that the mean length of stay improved significantly from 1.6 days with the drain to 0.5 days with ARTISS (Fig. 1) but without a difference in complication rate (Fig. 2), which was 5/17 (29%) in each group.

Conclusions

In conclusion, parotidectomy can be undertaken safely as a day-case procedure with the application of ARTISS. This new approach to parotid surgery not only offers less morbidity for patients but also positive financial revenue for public health institutions.
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Metadata
Title
Drain-free parotidectomy: a pilot study using ARTISS fibrin sealant
Authors
H. A. Cunniffe
B. L. K. Wong
A. W. Hilger
O. T. Burgan
Publication date
01-07-2019
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 7/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-019-05449-x

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