Orocutaneous and Pharyngocutaneous Fistula Closure Using a Vacuum-Assisted Closure System

Abstract

Objectives:

The vacuum-assisted closure (VAC) system is a topical negative pressure dressing that has been used extensively to manage a multitude of complicated wounds, including enterocutaneous fistula. We hypothesize that the VAC system may also facilitate the closure of orocutaneous and pharyngocutaneous fistulas.

Methods:

A retrospective chart review was performed.

Results:

Three patients were identified. Two patients developed fistulas after undergoing salvage laryngectomy, and 1 patient developed a fistula after having a hemiglossectomy defect reconstructed by a radial forearm free flap. The VAC system was successful in closing the fistula in 2 of the 3 patients. Complete fistula closure took 3 and 11 days in the 2 cases. The 1 failure of fistula closure was due to poor collapsibility of the neck tissue along the fistula tract caused by fibrosis following prior radiotherapy.

Conclusions:

The VAC system is a feasible treatment option for closing head and neck fistulas, especially when collapsible tissue is present at the fistula site.

Keywords

fistula closure salivary leak topical negative pressure dressing vacuum-assisted closure

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