title: Novel technique of creating a seal for the vacuum-assisted closure system application in complex head and neck wounds.
abstract: Achieving a good seal for the application of the vacuum-assisted closure (VAC) system in complex head and neck wounds is difficult.
  
  
  
  A case series of 4 patients who developed postoperative orocutaneous or pharyngocutaneous fistulas were studied. A sterile green glove was used as a sealant together with the VAC system.
  
  
  
  With utilization of a green glove, a good seal for the VAC system was obtained. This gave ample time to cleanse the wound and allow granulation tissue to form before proceeding on to the next stage of treatment.
  
  
  
  A green glove technique allows for a good seal for the VAC system to work, especially when applied to complex head and neck wounds. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2523-E2526, 2016.
authors.affiliation: Division of Surgical Oncology, National Cancer Centre Singapore, Singapore.
authors.forename: Brian
authors.initials: B
authors.lastname: Tian
authors.affiliation: Division of Surgical Oncology, National Cancer Centre Singapore, Singapore.
authors.forename: N Gopalakrishna
authors.initials: NG
authors.lastname: Iyer
authors.affiliation: Division of Surgical Oncology, National Cancer Centre Singapore, Singapore.
authors.forename: Hiang Khoon
authors.initials: HK
authors.lastname: Tan
authors.affiliation: Department of Nursing, Singapore General Hospital, Singapore.
authors.forename: Ai Choo
authors.initials: AC
authors.lastname: Tay
authors.affiliation: Division of Surgical Oncology, National Cancer Centre Singapore, Singapore.
authors.forename: Khee Chee
authors.initials: KC
authors.lastname: Soo
authors.affiliation: Division of Surgical Oncology, National Cancer Centre Singapore, Singapore.
authors.forename: Ngian Chye
authors.initials: NC
authors.lastname: Tan
mesh_terms: D000328:Adult; D017577:Cutaneous Fistula / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D011183:Postoperative Complications / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D013524:Surgical Flaps / Q000637:transplantation*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
keywords: breakdown; fistula; flap; novel; vacuum-assisted closure (VAC)