Management of orocutaneous fistulas using a vacuum-assisted closure system

Head Neck. 2014 Jun;36(6):873-81. doi: 10.1002/hed.23393. Epub 2013 Sep 11.

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).

Conclusion: VAC therapy is an effective treatment option for orocutaneous fistulas.

Keywords: anastomotic leak; pharyngocutaneous fistula; postoperative complications; salivary fistula; vacuum-assisted closure.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / surgery
  • Cutaneous Fistula / etiology
  • Cutaneous Fistula / therapy*
  • Dental Cements / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mouth Neoplasms / surgery
  • Negative-Pressure Wound Therapy*
  • Oral Fistula / etiology
  • Oral Fistula / therapy*
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Wound Healing

Substances

  • Dental Cements