title: Prevention of wound complications in salvage pharyngolaryngectomy by the use of well-vascularized flaps.
abstract: CONCLUSIONS
  We successfully reduced the incidence of pharyngocutaneous fistulas (PCFs) in high-risk patients undergoing surgery by using pectoralis major myocutaneous flaps (PMMCFs) and deltopectoral flaps (DPFs) to cover suture lines.
  
  
  OBJECTIVE
  We used coverage of suture lines with PMMCFs and DPFs in patients with high risk of PCFs undergoing total laryngectomy (TL) or total pharyngolaryngectomy (TPL) to determine whether coverage of suture lines during salvage surgery can reduce the incidence of PCFs.
  
  
  METHODS
  This retrospective study was based on a review of 52 patients who underwent salvage TL or TPL between 2001 and 2011; we have been using PMMCFs or DPFs during salvage surgery since 2008. Details of postoperative complications including PCFs were analyzed.
  
  
  RESULTS
  The incidence rate of PCF was lower in the flap group (7.7%) than that in the non-flap group (30.1%). No carotid ruptures were observed in the flap group (0%) as contrasted with patients in the non-flap group (7.7%).
authors.affiliation: Department of Otolaryngology, Tokai University, School of Medicine, Isehara, Japan. asakai-ygc@umin.ac.jp
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sakai
authors.forename: Kenji
authors.initials: K
authors.lastname: Okami
authors.forename: Ryousuke
authors.initials: R
authors.lastname: Sugimoto
authors.forename: Koji
authors.initials: K
authors.lastname: Ebisumoto
authors.forename: Hikaru
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Maki
authors.forename: Taku
authors.initials: T
authors.lastname: Atsumi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Iida
mesh_terms: D000368:Aged; D017577:Cutaneous Fistula / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy / Q000009:adverse effects*; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000009:adverse effects*; D013524:Surgical Flaps; D013536:Suture Techniques