Objectives: Drainless parotidectomy has been reported infrequently,
mostly in patients undergoing limited partial parotidectomies. Evicel is
a fibrin sealant (FS) glue whose use has not been reported in head and
neck surgeries so far. The aim of the study was to investigate the
impact of drainless parotidectomy using FS on the surgical outcome.
Design: A retrospective matched case-control series. Settings: A single
academic center, Participants: All cases of patients who underwent
drainless parotidectomies, including deep lobe tumors and revision
surgeries, were compared to age, sex, body mass index and tumor-matched
controls in which a suction drain was inserted. Main outcome measures:
length of hospital stay (LOS). Secondary outcomes included
post-operative seroma and related complications. Results: A total of 123
patients (41 cases and 82 controls) were included in the study.
Pre-operative and intra-operative characteristic did not differ
significantly between the FS group and controls. A borderline
significance was found for surgery type as the FS group had higher rates
of total parotidectomy compared with the control group (25.0% vs.
10.5%, p=0.054). LOS was significantly shorter in the FS group (1.0±0.3
vs. 1.5±0.6 days, p<0.001). The rates of post-operative
seroma, aspirations, local infection and post-operative antibiotic
treatment were all lower in the FS group compared with the control
group, but did not reach statistical significance. Conclusion: A
drainless parotidectomy using the EVICEL FS is safe, reduces LOS, and
may reduce post-operative seroma and its associated complications. This
procedure may be applied to deep parotid tumors, parapharyngeal
involvement and revision surgery.