Surgicel Use in Control of Primary Postadenoidectomy Bleeding

Although postadenoidectomy bleeding is a rare complication, it is serious and potentially fatal. Postnasal packing and cautery of the adenoid bed are the most popular methods of controlling postadenoidectomy bleeding. Many hazards and complications may arise from traditional nasopharyngeal packing and nasopharyngeal cautery. In this case series, oxidized regenerated cellulose (Surgicel Nu-Knit; Ethicon; Somerville, N.J) was inserted and used as postnasal packing to control primary postadenoidectomy bleeding in 9 cases after conventional curettage adenoidectomy. All patients underwent nasophayngoscopic examination with a 0° rigid telescope to re-curette if any remnant was still present, and were repacked with appropriate size ribbon gauzes for at least 15 minutes before applying Surgicel. Surgicel succeeded in controlling primary postadenoidectomy bleeding in all cases, with no need for any further intervention. At the 1-month follow-up, no complications were reported. We conclude that Surgicel postnasal pack effectively controls primary postadenoidectomy bleeding. Its many advantages make it superior to other traditionally used material. It is readily available, tolerable, relatively inexpensive, hemostatic, adhesive, freely reshaped, bactericidal, causes no granulation reaction, has no need to be removed, and the patient does not need to be in the ICU or sedated.