From the Research
Tonsil slough is best managed conservatively with supportive care as it is a normal part of healing after tonsillectomy. Patients should be reassured that the white or yellow patches in the throat are not infection but rather fibrin coating that forms as part of the normal healing process. Adequate pain control is essential, typically with acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (400-600mg every 6 hours for adults) 1. Avoid aspirin due to bleeding risk. Staying hydrated is crucial, and patients should drink cool liquids and eat soft foods. Cold foods like popsicles or ice cream can provide soothing relief. Saltwater gargles (1/4 teaspoon salt in 8 ounces of warm water) several times daily can help with discomfort and keep the area clean. Patients should be advised that slough typically resolves on its own within 7-14 days post-surgery as healing progresses.
Some key points to consider in the management of tonsil slough include:
- The importance of differentiating between sore throat and tonsillitis, as the treatment approach may vary 2
- The use of scoring systems, such as the Centor score, to estimate the probability of bacterial tonsillitis 3
- The role of tonsillectomy in the management of recurrent acute tonsillitis, which has been shown to be effective in reducing sore throat days 4
- The potential benefits and risks of antibiotic therapy, including the use of penicillin and clindamycin 5
Medical attention should be sought if there is excessive bleeding, severe pain uncontrolled by prescribed medications, signs of infection (fever above 101°F, increasing pain, foul odor), or inability to maintain hydration. It is essential to prioritize the patient's comfort and safety during the healing process, and to be aware of the potential complications that may arise. By providing supportive care and monitoring the patient's condition, healthcare providers can help ensure a smooth and successful recovery from tonsillectomy.