title: Coated collagen patches for closure of pharyngo-cutaneous fistulas.
abstract: After laryngectomy or lateral pharyngotomy for treatment of laryngeal or hypopharyngeal cancer the occurrence of a pharyngo-cutaneous fistula is a challenging complication. Especially after previous radiotherapy and expanded surgical resections of mucosa the management is demanding. Besides the prolonged hospital stay, increased treatment costs and reduced quality of life, a delayed adjuvant treatment follows the development of a fistula. Treatment strategies range from conservative procedures comprising parenteral nutrition, antibiotics and local wound care to primary surgical closure or reconstructive tissue transfer. We report three cases of using the fibrin/thrombin-coated collagen patch TachoSil(®) as a solitary or adjuvant strategy in surgical treatment. In one patient primary closure of the fistula was achieved by transoral application of the collagen patch. In the other cases a not tension free primary suture was strengthened by the adjuvant use of TachoSil(®). The healing process was rapid and straightforward in all patients. The use of TachoSil(®) may be indicated in between conservative treatment strategies and reconstructive surgery. After occurrence of a fistula the healing process is intended to be accelerated by primary closure with TachoSil(®) or by sealing of a primary suture.
authors: Department of Otolaryngology, Head and Neck Surgery, University of Göttingen.
authors: Bernhard G
authors: BG
authors: Weiss
authors: Department of Otolaryngology, Head and Neck Surgery, University of Göttingen.
authors: Friedrich
authors: F
authors: Ihler
authors: Department of Otolaryngology, Head and Neck Surgery, University of Göttingen.
authors: Christoph
authors: C
authors: Matthias
authors: Department of Otolaryngology, Head and Neck Surgery, University of Göttingen. Electronic address: martin.canis@med.uni-goettingen.de.
authors: Martin
authors: M
authors: Canis
mesh_terms: D003094:Collagen / Q000008:administration & dosage*; D017577:Cutaneous Fistula / Q000601:surgery*; D004338:Drug Combinations; D005340:Fibrinogen / Q000008:administration & dosage*; D005402:Fistula / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D010608:Pharyngeal Diseases / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D015503:Surgical Sponges; D013917:Thrombin / Q000008:administration & dosage*; D014945:Wound Healing
chemical_list: D004338:Drug Combinations; C518955:TachoSil; D005340:Fibrinogen; D003094:Collagen; D013917:Thrombin