Post-tonsillectomy bleeding is thought to occur in approximately 5% of cases following tonsil surgery. A bleed in the first 24 hours is considered a PRIMARY bleed and those occurring after 24 hours are a SECONDARY bleed (most frequently in days 5-9, up to 28 days).
Most scabs only last 5-10 days. Then, they naturally flake off. Tonsillectomy scabs may last longer on larger wounds created when large tonsils are removed. Also, people who have poor nutrition may heal slower than people who maintain a healthy diet.
Delayed postoperative haemorrhage (>24 h) predominantly occurs on the fifth to seventh-day postoperatively when the slough separates from the granulating fossa. The most critical posttonsillectomy haemorrhages are due to arterial dissections and aneurysms.
If bleeding after tonsillectomy is going to occur, it is most likely to start after surgery or about a week later when the scabs come off. Bleeding can also occur at any point in the recovery process, which takes around two weeks.
Between days 5 and 10 after surgery, the tonsillectomy scabs will fall off. This may cause a small amount of bleeding, and some people will notice specks of blood in their saliva. Blood may cause people some concern, but it is a normal part of healing.
If a high temperature (fever) develops in the week or two after a tonsillectomy, see your GP as soon as possible. This may suggest infection, and treatment with antibiotics may be necessary. If there is any fresh bleeding from the back of the throat after a tonsillectomy you should contact your GP urgently.
Post-tonsillectomy bleeding may be managed with observation, bedside interventions, or surgery. Maneuvers to control bleeding include electrocautery, application of topical hemostatic agents, direct pressure to the site of bleeding, and suturing of the tonsillar pillars [3,4].
Secondary hemorrhage, or postoperative bleeding after 24 hours, has as its origin the sloughing of eschar, trauma secondary to solid food ingestion, tonsil bed infection, postoperative nonsteroidal anti-inflammatory drug usage, or idiopathic causes.
Post-tonsillectomy bleeding is thought to occur in approximately 5% of cases following tonsil surgery. A bleed in the first 24 hours is considered a PRIMARY bleed and those occurring after 24 hours are a SECONDARY bleed (most frequently in days 5-9, up to 28 days).
After tonsillectomy, typically dark spots of blood in your saliva or a few streaks of blood in your vomit. A small amount of bleeding may also occur about a week after surgery as your scabs mature and fall off. This is not something to worry about.
The most common complications include bleeding and respiratory compromise. Complications have been divided into “early” complications (primary hemorrhage and respiratory compromise) and “late” complications (dehydration and secondary hemorrhage).
Your child may have a sore throat, neck and/or ear pain for 2-3 weeks after surgery. The pain may be the worst for 3-4 days after surgery. One to two weeks after surgery, pain may worsen because the scabs are falling off.
Most people find that they have the most pain in the first 8 days. You probably will feel tired for 1 to 2 weeks. You may have bad breath for up to 2 weeks. You may be able to go back to work or your usual routine in 1 to 2 weeks.
The pain was evaluated using visual analogue scale (VAS) on a scale of 0–10, with 0 representing no pain at all and 10 worst possible pain. Postoperative pain was consider mild if EVA ranges between 0.00 and 2.99; moderate when ranges between 3.00 and 6.99, and severe pain when it was greater than 7.00.
If the fever continues for more than two days, or if a higher fever develops, call your surgeon. Fever can show that you have not drank enough fluids or may have an infection. Post-operative bleeding is unusual, but it can occur up to two weeks after surgery. Watch for spitting, coughing, or vomiting blood.
This is normal and is due to the cauterization of the tonsil blood vessels that forces the uvula to swell up until the glands develop an alternative drainage pattern. This can cause patients to have a sensation of something in their throat and feel that their throat is “blocked”.
It can result in dysphagia or the feeling of something stuck at the back of the throat, a sensation that can be worrisome to patients. Oedema typically resolves spontaneously within a few days; however, oral steroids may be required in severe cases.
The most common serious complication of tonsillectomy is delayed hemorrhage, which occurs in 2% to 4% of all patients. In addition, an expected sequela of the procedure is pain, which typically lasts from 7 to 10 days and can be moderate to severe in intensity.
You should rest at home for the first 48 hours. Activity may increase as strength returns. Generally, you may return to work approximately 10 days following a tonsillectomy, and about 3 days after an adenoidectomy. You should avoid vigorous activity for 14 days after surgery.
Some common complications of tonsillectomy are postoperative infection, bleeding, edema of the tongue, glossopharyngeal nerve injury, and carotid artery injury.
Some patients find that small sips of ginger ale or a cola drink may help to relieve nausea. Small portions of bananas, applesauce, moistened graham crackers or soda crackers may be helpful prior to taking medications. You may wish to avoid acidic products such as orange juice.
THROAT PAIN is normal for 21 days after the surgery. The pain is usually tolerable in the first 3 days and then worsens to a crescendo around day 6 to 9 after the operation. Once this peak is reached then the pain gradually decreases daily until you can comfortably eat around day 14 after the operation.
The tonsil beds will be coated in a whitish layer of slough in the days just after surgery. This is NOT infection, but a fibrinous exudate coating the raw tissue. It is analogous to the black scab forming over skin abrasions. The white slough will fall off returning to pink ~7-10 days post op.