Topical autologous platelet-rich plasma was associated with reduced postoperative pain and improved wound healing following tonsillectomy in a randomized controlled trial of 200 patients.
In the prospective randomized controlled trial, Sedat Rüzgar of Bağcılar Training and Research Hospital, Istanbul, Turkey, and colleagues assigned patients aged 8 to 29 years undergoing bilateral tonsillectomy, with or without adenoidectomy, to receive intraoperative platelet-rich plasma or platelet-poor plasma placebo control. Patients and postoperative outcome assessors were blinded. The primary outcome was postoperative pain measured daily for 10 days using a visual analog scale. Secondary outcomes included wound healing, complete mucosal healing by day 14, hemorrhage, and complications.
Among 195 patients included in the analysis, postoperative pain over days 1 to 10 was lower in the platelet-rich plasma group, with a mean difference of −0.8 points on the visual analog scale. Statistically significant differences were observed on postoperative days 1 through 8, but not on days 9 and 10. Median pain scores were 6 vs 7 on day 1 and 1 vs 2 on day 8 in the platelet-rich plasma vs control groups.
Wound healing outcomes also favored platelet-rich plasma. Healing scores were better on postoperative days 7, 10, and 14, and complete mucosal healing by day 14 occurred in 78% of patients receiving platelet-rich plasma vs 59% of controls. No patients showed signs of wound infection or abnormal granulation tissue.
Secondary hemorrhage occurred in 2% of patients in the platelet-rich plasma group vs 5% in the control group, with no statistically significant difference. No primary hemorrhage or serious adverse events were reported.
All patients underwent standardized cold-dissection tonsillectomy with consistent perioperative care. Platelet-rich plasma was prepared intraoperatively from autologous blood using centrifugation and applied topically to both tonsillar fossae, while control patients received platelet-poor plasma using the same protocol to maintain blinding.
The study was limited by its single-center design, lack of age-stratified analyses, and inability to blind the operating surgeon during application. The trial was also not powered to detect differences in rare outcomes such as hemorrhage.
“Topical autologous platelet-rich plasma applied during tonsillectomy was associated with reduced postoperative pain and improved wound healing compared with control treatment,” the researchers wrote, adding that it “may be a useful adjunct for enhancing early recovery after tonsillectomy.”
The researchers reported no competing interests and no external funding.