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.