Usefulness of a Pouch for Management of Postoperative Pharyngocutaneous Fistula (original) (raw)
Nippon Jibiinkoka Tokeibugeka Gakkai Kaiho(Tokyo)
Postoperative saliva leakage associated with wound dehiscence is one of the serious postoperative complications of major head and neck oncological surgery. Usually, a pharyngocutaneous fistula has to be formed for appropriate drainage of the infectious saliva to protect cervical vital structures, including the carotid artery. After the microvascular circulation around the fistula becomes stable, the fistula can be closed safely using a hinge flap and local rotation or a free island flap. Conventionally, the pharyngocutaneous fistula is maintained by plugging it with ointment gauze and covering it tightly with dry gauze and adhesive tapes ; the tracheal stoma has to be managed with a cuffed cannula to prevent aspiration of saliva. However, this conventional method is associated with heavy distress to the patient, such as skin damage and pain due to frequent replacement of gauze and tapes, and increased cough and sputum induced by the
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