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Background: Secondary posttonsillectomy haemorrhage (sPTH) is a significant complication inOtolaryngology. Most studies have focussed on different risk factors associatedwith sPTH. However, few studies have reported on the outcomes of sPTH afterpresentation to a tertiary public hospital. We sought to present our experiencewith the management of sPTH.  Methods: A retrospectivereview of all patients (n=145) presenting with a sPTH to Flinders MedicalCentre (FMC) was analysed over a two-year period. The Stammberger grade forsPTH was applied and recorded in the case notes at presentation of allpatients.  Results: 59% of thesepatients were adults. Overall, 79% of patients were conservatively treated anddischarged safely without returning to the operating theatre. Adults weremarginally more likely to return to theatre (RTT) with a relative risk (RR) of1.07 (CI 0.5–2.3). Patients who had coblation (COB) tonsillectomy had a higherRR of RTT (RR =1.45) compared to cold steel (CS) tonsillectomy. Patients whohad a COB tonsillectomy (16.6%) were also more likely represent with a secondbleeding episode compared to CS tonsillectomy (9.8%). The length of stay (LOS)was significantly longer (13 hours) in adults with Stammberger grade C sPTH(P<0.05) compared to grade A1 sPTH, with other factors having no significanteffect on LOS.  Conclusions: The overall riskof a second bleeding episode is low in patients with sPTH, and conservativemanagement in the first instance is safe. Patients with a COB tonsillectomy arelikely to present with multiple episodes of sPTH if initial management wasconservative. Stammberger grade at initial sPTH presentation is not predictiveof subsequent presentations.

Management of post tonsillectomy secondary haemorrhage: Flinders experience