Are Mastoid Pressure Dressings Necessary after Otologic Surgery to Prevent Postoperative Hematomas?

Background

The use of mastoid pressure dressings following otologic surgery is a common practice. Many styles of commercially available or improvised pressure dressings are available. The primary purpose of all such dressings is to prevent postoperative wound hematomas or seromas. Either complication may cause the patient pain, necessitate drainage, or increase the risk of postoperative wound infection. Does the routine use of mastoid pressure dressings, however, decrease the risk of postoperative complications? Although placing a mastoid pressure dressing is a relatively simple endeavor, one must balance potential efficacy with considerations of cost, both in time and monetary expense, and potential risk of pressure-induced complications such as headache and focal skin necrosis.

Best Practice

The available evidence does not support the routine use of a mastoid pressure dressing to prevent hematoma formation following otologic surgery. Surgeons should adhere to principles of good hemostasis and appropriate would closure to prevent postoperative wound complications. There is, however, no literature studying other potential benefits of mastoid dressings, such as collecting postoperative drainage, protecting the wound from trauma (particularly important in young children), and psychological benefits to patients and family. For these reasons, loose mastoid dressings may be indicated and beneficial. Read the full article in The Laryngoscope.