To the Editor.—I have used bismuth subgallate during tonsillectomies for a number of years, and have often wondered what, if any, good I was doing by employing this technique. The referenced article was very enlightening in that regard.1 It described a technique for hemostasis that minimized postoperative bleeding and therefore made this procedure safe to perform on an outpatient basis.
My clinical experience leads me to believe that postoperative hemorrhage is not one of the more common problems patients experience during the immediate postoperative period. Many patients often seem to have problems related to pain and dysphagia during the immediate postoperative period that may require intravenous fluid and intramuscular analgesics. These problems can be compounded by emesis and may rapidly lead to dehydration and electrolyte abnormalities that cannot be dealt with at home. This situation is more apt to occur in older children and adults than in young
ALPERN G. Adenotonsillectomy: A Safe Outpatient Procedure. Arch Otolaryngol Head Neck Surg. 1989;115(6):749. doi:10.1001/archotol.1989.01860300103028