Use of Parotid Pressure Bandage for Drainless Parotidectomies: A Modification of an Old Technique

Abstract

Objective: The use of fibrin glue has been described in parotidectomies to obviate the need for drains. However, the seroma rate postoperatively can be high. We have modified this technique so as to achieve the same successes without the seroma.

Method: A prospective, randomized, case-control study on 54 patients undergoing superficial parotidectomies. All patients had fibrin glue sprayed on the parotid bed intraoperatively. In group A, a pressure bandage was applied over the parotid area for 12 hours postoperatively. In group B, no pressure bandage was used.

Results: Group A patients stayed an average of 1.1 days postoperatively while Group B patients stayed 1.6 days. The cost savings in terms of hospitalization was $150 for group A patients. The seroma rate detected postoperatively was 10% for Group A patients but 53% in Group B patients. Among all patients with seromas, the average volume of parotid tissue removed was significantly higher at 71 cm³ compared with patients without seroma, whose average volume of parotid tissue removed was 44 cm³.

Conclusion: This paper has shown that it is safer and cheaper to perform parotid surgery with fibrin glue and a parotid bandage. The rate of seroma is related to the volume of parotid tissue removed.