1. Drain-free parotidectomy: a pilot study using ARTISS fibrin sealant
- Author
-
H A Cunniffe, O T Burgan, A W Hilger, and B L K Wong
- Subjects
Adult ,Male ,medicine.medical_specialty ,Partial parotidectomy ,Pilot Projects ,Fibrin Tissue Adhesive ,Fibrin ,Hemostatics ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Cost Savings ,medicine ,Humans ,Parotid Gland ,030223 otorhinolaryngology ,Fibrin glue ,Retrospective Studies ,Hematoma ,biology ,business.industry ,Fibrinogen ,Retrospective cohort study ,General Medicine ,Parotidectomy ,Middle Aged ,medicine.disease ,United Kingdom ,Surgery ,Seroma ,Otorhinolaryngology ,Ambulatory Surgical Procedures ,030220 oncology & carcinogenesis ,biology.protein ,Female ,Neurosurgery ,Parotid Diseases ,business - Abstract
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. 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. 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. 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.
- Published
- 2019