title: Management of orocutaneous fistulas using a vacuum-assisted closure system.
abstract: BACKGROUND
  The vacuum-assisted closure (VAC) system has been used to manage complicated wounds. The purpose of this study was to describe a novel technique in using the VAC system for orocutaneous fistulas.
  
  
  METHODS
  A retrospective study was performed on 10 patients treated at the National Cancer Centre, Singapore, who developed postoperative orocutaneous fistulas. Hydrogum dental paste was used as a sealant together with the VAC system to close the fistulas. We used either the RENASYS or VAC ATS system with 50 mm Hg to 125 mm Hg continuous suction.
  
  
  RESULTS
  The 10 patients developed 11 fistulas. The median age of this cohort was 67 years (range, 33-80 years). Nine patients had successful closure of their fistulas with VAC therapy whereas 1 patient had unsuccessful VAC therapy and required flap reconstruction. The median time to fistula closure was 19 days (range, 6-36 days). The median time to radiotherapy after surgery was 46 days (range, 26-62 days).
  
  
  CONCLUSIONS
  VAC therapy is an effective treatment option for orocutaneous fistulas.
authors.affiliation: Department of Surgical Oncology, National Cancer Centre Singapore, Singapore.
authors.forename: Brian
authors.initials: B
authors.lastname: Tian
authors.forename: Deborah
authors.initials: D
authors.lastname: Khoo
authors.forename: Ai Choo
authors.initials: AC
authors.lastname: Tay
authors.forename: Khee-Chee
authors.initials: KC
authors.lastname: Soo
authors.forename: Ngian Chye
authors.initials: NC
authors.lastname: Tan
authors.forename: Hiang Khoon
authors.initials: HK
authors.lastname: Tan
authors.forename: N Gopalakrishna
authors.initials: NG
authors.lastname: Iyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D017577:Cutaneous Fistula / Q000209:etiology / Q000628:therapy*; D003738:Dental Cements / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery; D054843:Negative-Pressure Wound Therapy; D016155:Oral Fistula / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D003738:Dental Cements
keywords: anastomotic leak; pharyngocutaneous fistula; postoperative complications; salivary fistula; vacuum-assisted closure