CC BY 4.0 · Int Arch Otorhinolaryngol
DOI: 10.1055/s-0043-1777295
Original Research

Posttonsillectomy Pain Relief and Wound Healing by Applying Bismuth Iodoform Paraffin Paste (BIPP) to Dissected Tonsillar Beds

Rahimah Idris
1   Department of Otorhinolaryngology, Head and Neck Surgery, Pantai Hospital Laguna Merbok, Bandar Laguna Merbok, Sungai Petani, Kedah, Malaysia
2   Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
Wan NorSyafiqah W Yaacob
2   Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
3   International Medical University (IMU) Centre for Education, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
› Author Affiliations
Funding The authors declare that they have received no financial support from agencies in the public, private or non-profit sectors to conduct the present research.


Introduction Tonsillectomy is one of the most common operations performed by otorhinolaryngology surgeons worldwide; however, the insufficient quality of the postoperative pain management and effective posttonsillectomy pain relief remain a clinical dilemma.

Objective To evaluate the efficacy of applying bismuth iodine paraffin paste (BIPP) to the dissected fossa as an adjuvant therapy for a better outcome in terms of posttonsillectomy pain management and due to its wound healing properties.

Methods The present is a prospective randomized control pilot study with 44 patients aged > 7 years who underwent tonsillectomy. The patients were divided into two groups: the control group and the group that had BIPP applied to the dissected tonsillar fossa. The visual analogue scale score and the post-onsillectomy percentage of tonsillar fossa epithelization were recorded and evaluated.

Results Both subjectively and objectively, there a was statistically significant pain-relieving effect in the BIPP group within the first 5 postoperative days (p < 0.05). From postoperative day 3 onward, the dissected area of the tonsillar fossa healed significantly faster in the BIPP group compared with the control group, and it became stable on day 14.

Conclusion The topical application of BIPP showed a better pain-relieving effect, it was safe, and hastened wound healing after tonsillectomy.

Publication History

Received: 11 April 2023

Accepted: 15 October 2023

Article published online:
19 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (

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