title: Orocutaneous and pharyngocutaneous fistula closure using a vacuum-assisted closure system.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Iowa College of Medicine, Iowa City, Iowa 52242, USA.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Andrews
authors.forename: Russell B
authors.initials: RB
authors.lastname: Smith
authors.forename: Henry T
authors.initials: HT
authors.lastname: Hoffman
authors.forename: Gerry F
authors.initials: GF
authors.lastname: Funk
mesh_terms: D000368:Aged; D017577:Cutaneous Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007825:Laryngectomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D016155:Oral Fistula / Q000209:etiology / Q000601:surgery*; D010608:Pharyngeal Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D016156:Respiratory Tract Fistula / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome