Utility of Applying Pressure Dressing Following Parotidectomy Compared to Conventional Dressing: A Benefit or Not?

Abstract

BackgroundPost-parotidectomy wound dressing techniques lack of robust evidence, creating variation in practice. The choice between conventional and pressure dressing is typically based on expert opinions and individual preferences and the anticipated benefits of reduced drainage and shorter drain retention in pressure dressing hasn’t demonstrate yet. PurposeThe purpose of this study is to assess the advantage of pressure dressing following parotidectomy compared to conventional dressing. Study design, setting, sampleThis study was a open-label randomized controlled trial recruiting the patients aged 18 and above undergoing parotidectomy at the Otolaryngology Department of King Chulalongkorn Memorial Hospital between March 2021 and September 2022. Our exclusion criteria were as following: (1) underwent parotidectomy combined with neck dissection, (2) prior irradiation to the parotid gland or head and neck region, (3) prior parotidectomy within the previous year, (4) consumption of anticholinergic medications, (5) bleeding disorders or coagulopathies. Predictor/exposure/independent variableThe predictor variable was postoperative dressing and subjects were randomly assigned to pressure or conventional dressing Main outcome variable(s)The primary outcome variables were drain output (ml) measured every 8 hours and reported in the term of total drain output and duration of drain use. The secondary outcome variables were post-parotidectomy complications (if any), complications from the pressure dressing and pain scores. CovariatesThe covariates were underlying disease, smoking, alcohol drinking, types of parotidectomy (extension of surgery) and pathologic result. AnalysesThe appropriate uni- and bivariate statistics were computed, and the level of statistical significance was set at P-value < 0.05. ResultsA total of 40 patients were enrolled, with 20 in each group. Average age was 59.10±10.60 years in pressure dressing group and 55.70±18.90 years in conventional dressing group. Baseline characteristics were the same in both groups. The average volume of drain output in the pressure dressing group was 44.25 ± 25.20 ml, compared to 37.05 ± 22.74 ml in the conventional dressing group (p = 0.34). Moreover, the average duration of drain placement for the pressure dressing group was 27.65 ± 9.86 hours, while it was 26.90 ± 11.23 hours for the conventional group (p = 0.83). Notably, there were no significant differences between the two groups regarding sialocele and pain scores. Furthermore, no complications from the application of pressure dressing were observed. Conclusions and RelevancePressure dressing does not provide significant benefits over conventional dressing after parotidectomy concerning drain output, duration of drain placement, or surgical complications.