Orocutaneous and pharyngocutaneous fistula closure using a vacuum-assisted closure system
Brian T Andrews1, Russell B Smith, Henry T Hoffman
1Department of Otolaryngology-Head and Neck Surgery, University of Iowa College of Medicine, Iowa City, Iowa 52242, USA.
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.
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