Secondary post-tonsillectomy bleeding is a nightmare for all E.N.T. specialists as it may occur at an inappropiate and unexpected time. I could aviod this situation by revising the patient on the 5th. day post-operatively. The aim of that revision is to remove the ligatures, stitches and tonsillar reminants off the tonsillar bed. This procedure has three goals:

(1)To prevent secondary haemorrhage before it occurs on the sixth or seventh post-operative days dew to erosion of the ends of the blood vessels by the anaerobic bacteria (fusiform bacilli).

(2) Relief of post-operative pain by removal of the necrotized tissues which are very irritable to the healthy nieghbouring  tissues.  

(3) Avoid leaving tonsillar tissues which may grow to a considerable size.

This procedure is achieved by Luck's forcepse without anaesthesia. 

The bleeding occurring during this procedure is self-limited. 

I 've never seen any case of that haemorrhage over more than twenty years (about7000 cases )

Dr Ahmad Farrage

Ear, Nose And Throat Consultant

Qina .Egypt