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Haemostatic devices in parotid surgery: a systematic review

Published online by Cambridge University Press:  23 August 2021

L Allen ,
C MacKay ,
M H Rigby ,
J Trites  and
S M Taylor
L Allen
Affiliation:
Faculty of Medicine, QEII Health Sciences Centre, Dalhousie University, Halifax, Canada
C MacKay
Affiliation:
Division of Otolaryngology – Head & Neck Surgery, QEII Health Sciences Centre, Dalhousie University, Halifax, Canada
M H Rigby
Affiliation:
Division of Otolaryngology – Head & Neck Surgery, QEII Health Sciences Centre, Dalhousie University, Halifax, Canada
J Trites
Affiliation:
Division of Otolaryngology – Head & Neck Surgery, QEII Health Sciences Centre, Dalhousie University, Halifax, Canada
S M Taylor*
Affiliation:
Division of Otolaryngology – Head & Neck Surgery, QEII Health Sciences Centre, Dalhousie University, Halifax, Canada
*
Author for correspondence: Dr S M Taylor, Division of Otolaryngology – Head and Neck Surgery, Dalhousie University, Dickson Building, QEII Health Sciences Centre, 5820 University Avenue, HalifaxB3H 2Y9, Canada E-mail: smarktaylor@eastlink.ca
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Abstract

Objective

The Harmonic Scalpel and Ligasure (Covidien) devices are commonly used in head and neck surgery. Parotidectomy is a complex and intricate surgery that requires careful dissection of the facial nerve. This study aimed to compare surgical outcomes in parotidectomy using these haemostatic devices with traditional scalpel and cautery.

Method

A systematic review of the literature was performed with subsequent meta-analysis of seven studies that compared the use of haemostatic devices to traditional scalpel and cautery in parotidectomy. Outcome measures included: temporary facial paresis, operating time, intra-operative blood loss, post-operative drain output and length of hospital stay.

Results

A total of 7 studies representing 675 patients were identified: 372 patients were treated with haemostatic devices, and 303 patients were treated with scalpel and cautery. Statistically significant outcomes favouring the use of haemostatic devices included operating time, intra-operative blood loss and post-operative drain output. Outcome measures that did not favour either treatment included facial nerve paresis and length of hospital stay.

Conclusion

Overall, haemostatic devices were found to reduce operating time, intra-operative blood loss and post-operative drain output.

Keywords

Facial ParalysisLength Of StayDissectionSalivary GlandsHemostaticsCautery
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 10 , October 2021 , pp. 848 - 854
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr S M Taylor takes responsibility for the integrity of the content of the paper

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