Tonsillectomy Care

Tonsillectomy involves dissection and removal of the palatine tonsils from the pharyngeal musculature. The tonsillar fossa receives its blood supply primarily from the tonsillar branch of the facial artery, ascending pharyngeal artery, and dorsal lingual artery. Intraoperative hemostasis is achieved through electrocautery, suture ligation, or chemical cauterization. A fibrin eschar forms over the wound bed within 24 hours and provides a biological dressing during the 10-14 day healing period. Primary hemorrhage occurs within the first 24 hours from inadequate hemostasis. Secondary hemorrhage occurs at days 5-10 when the eschar separates from the healing granulation tissue below. The nurse must implement comprehensive hemorrhage surveillance, manage multimodal analgesia, ensure adequate hydration, coordinate discharge education, and recognize signs of airway compromise.