Introduction
Use of fibrin sealants (FS) has been shown to reduce post-operative
secretion and length of hospital stay (LOS) in different types of head
and neck surgeries, mostly thyroidectomies, but also parotidectomies and
neck dissections
[1,2,3,4,5, 6, 7].
While FS use in thyroid surgery is well established, with several
randomized controlled trials and meta analyses suggesting improvement in
the post-operative course [1,8], data on the outcome of FS-based drainless
parotid surgeries remains limited [3,4, 5, 9,10]. Previous reports on FS-based drainless
parotidectomies have shown improved outcomes compared with the
traditional approach of drain insertion, resulting in shorter LOS and
reduced post-operative seroma rates [4,5]. Despite the encouraging results in published
data, the vast majority of parotid surgeons would still insert a drain
in virtually all of their patients. Possible explanations for this are
concerns regarding secretion of saliva from the remaining parotid tissue
as well as the potential dead space. Therefore, additional studies on
the outcome of FS use in parotid surgery are still needed in order to
consider drainless parotidectomy with FS as the standard of care.
FS contain fibrinogen and thrombin frozen solutions. These components
act to form a clot which adheres to the wound surface and seals small
blood vessel.
The aim of this matched case-control study was to evaluate the impact of
drainless parotidectomy using FS on LOS, post-operative seroma and
related complications in a consecutive group of patients who underwent
parotidectomies in our department.