Is There Utility in Using Mastoid Pressure Dressing in Children
Undergoing a Mastoidectomy?
Abstract
Objectives: To assess the efficacy of avoiding mastoid pressure dressing
(MPD) on children as a means of preventing discomfort and postoperative
pain. Design: A retrospective controlled study. Setting: All operations
were carried out by experienced surgeons using standard techniques,
whose custom, not the gravity of any individual case, dictated the use
of MPD. Participants: children who underwent mastoidectomy for
inflammatory middle ear diseases at a tertiary centre from 2010-2020.
Main outcome measures: Wound-related complications and visual analog
scale (VAS) pain scores at discharge were compared between children who
had a MPD applied following surgery and those who did not. Results: 119
cases were included. The demographic characteristics of the patients and
surgical techniques employed similar for both groups. There were 91
patients in the MPD group and 28 in the non-mastoid dressing (NMPD)
group. In the MPD group, 5 patients developed minor wound dehiscence, 8
experienced surgical site infections (SSI), and one patient developed a
keloid. In the NMPD group, one patient had a SSI, while another had a
local hematoma. Therefore, there were no differences between the groups
in relation to postoperative complications (p = 0.47). Despite these
similitudes, the NMPD patients suffered less postoperative pain, as
measured by the VAS (p =.02). Conclusions: This study shows that no
significant benefit is derived from using a MPD after mastoidectomy in
children. Surgeons should adhere to principles of appropriate
haemostasis and wound closure to prevent postoperative wound
complications. Our study supports the abandonment of routine MPD on
children following mastoidectomy.