Cervical Hematoma and Wound Complications

Although thyroid surgery is a relatively safe procedure, it may be associated with some clinically concerning postoperative complications, including postoperative cervical hematoma, incision infection, hypocalcemia, and in some cases vocal cord paralysis. Of these, the development of postoperative cervical hematoma may lead to symptoms of compression causing airway obstruction, respiratory distress, or even death due to suffocation. Therefore, post-thyroidectomy hematoma requires emergency management. Postoperative care includes attention to the drain, careful monitoring in the recovery room and appreciation of subtle signs of respiratory distress. Prevention and early intervention can avoid fatal complications. Thyroid surgery is a clean procedure because the infection rate is very low. For these reasons, antibiotic prophylaxis is not routinely recommended by most international guidelines. However, antibiotics are not rarely used in clinical practice with rates as high as 50% of cases. Despite its low incidence, post-thyroidectomy surgical site infection (frequently caused by Group A Streptococcus) is especially concerning because of its proximity to vital head and neck structures and the very real potential for airway compromise and death.