Management of Pharyngocutaneous Fistula With Negative-Pressure Wound Therapy.
BACKGROUND
Pharyngocutaneous fistula is a common complication of laryngopharyngeal surgery and is associated with increased morbidity and mortality. Beyond the classical management, negative-pressure wound therapy (NPWT) can be an alternative and effective treatment.


METHODS
Two patients with pT3N0M0 squamous cell carcinoma of pyriform sinus were subjected to total laryngectomy and pharyngoesophageal reconstruction of a circular (patient 1) and an anterior wall defect (patient 2) with radial forearm free flap and pectoralis major muscle flap, respectively. Both developed a pharyngocutaneous fistula and NPWT was used.A significant decrease of the fistula aperture and exudate was observed after 22 and 21 days of NPWT in patients 1 and 2, respectively. After that standard wound care was instituted and closure of the fistulae was accomplished in 5 and 7 days, respectively.


CONCLUSIONS
Negative-pressure wound therapy can be an effective treatment for pharyngocutaneous fistula closure, either in the setting of fistulae that persist besides multiple surgical revisions using muscle flaps or as a first-line therapy when fistulae develops.
Department of Plastic, Reconstructive and Aesthetic Surgery and Burn Unity, Centro Hospitalar de São João, Porto, Portugal.
Sérgio
S
Teixeira
Joana
J
Costa
Isabel
I
Bartosch
Bernardo
B
Correia
Álvaro
Á
Silva
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D017577:Cutaneous Fistula / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007825:Laryngectomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D010608:Pharyngeal Diseases / Q000209:etiology / Q000628:therapy*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D013524:Surgical Flaps; D016896:Treatment Outcome