Incorporating a continuous suction system as a preventive measure against fistula-related complications in head and neck reconstructive surgery

Hsien Pin Chang, Jong Won Hong, Won Jai Lee, Young Seok Kim, Yoonwoo Koh, Se Heon Kim, Dae Hyun Lew, Tae Suk Roh

Research output: Contribution to journalArticle

Abstract

Background Although previous studies have focused on determining prognostic and causative variables associated with fistula-related complications after head and neck reconstructive surgery, only a few studies have addressed preventive measures. Noting that pooled saliva complicates wound healing and precipitates fistula-related complications, we devised a continuous suction system to remove saliva during early postoperative recovery. Methods A continuous suction system was implemented in 20 patients after head and neck reconstructive surgery between January 2012 and October 2017. This group was compared to a control group of 16 patients at the same institution. The system was placed orally when the lesion was on the anterior side of the retromolar trigone area, and when glossectomy or resection of the mouth floor was performed. When the orohypopharynx and/or larynx were eradicated, the irrigation system was placed in the pharyngeal area. Results The mean follow-up period was 9.2 ±2.4 months. The Hemovac system was applied for an average of 7.5 days. On average, 6.5 days were needed for the net drain output to fall below 10 mL. Complications were analyzed according to their causes and rates. A fistula occurred in two cases in the suction group. Compared to the control group, a significant difference was noted in the surgical site infection rate (P<0.031). Conclusions Clinical observations showed reduced saliva pooling and a reduction in the infection rate. This resulted in improved wound healing through the application of a continuous suction system.

Original languageEnglish
Pages (from-to)449-459
Number of pages11
JournalArchives of Plastic Surgery
Volume45
Issue number5
DOIs
Publication statusPublished - 2018 Sep 1

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Reconstructive Surgical Procedures
Suction
Fistula
Neck
Head
Saliva
Wound Healing
Glossectomy
Mouth Floor
Surgical Wound Infection
Control Groups
Larynx
Infection

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Chang, Hsien Pin ; Hong, Jong Won ; Lee, Won Jai ; Kim, Young Seok ; Koh, Yoonwoo ; Kim, Se Heon ; Lew, Dae Hyun ; Roh, Tae Suk. / Incorporating a continuous suction system as a preventive measure against fistula-related complications in head and neck reconstructive surgery. In: Archives of Plastic Surgery. 2018 ; Vol. 45, No. 5. pp. 449-459.
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Incorporating a continuous suction system as a preventive measure against fistula-related complications in head and neck reconstructive surgery. / Chang, Hsien Pin; Hong, Jong Won; Lee, Won Jai; Kim, Young Seok; Koh, Yoonwoo; Kim, Se Heon; Lew, Dae Hyun; Roh, Tae Suk.

In: Archives of Plastic Surgery, Vol. 45, No. 5, 01.09.2018, p. 449-459.

Research output: Contribution to journalArticle

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AU - Chang, Hsien Pin

AU - Hong, Jong Won

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AU - Kim, Young Seok

AU - Koh, Yoonwoo

AU - Kim, Se Heon

AU - Lew, Dae Hyun

AU - Roh, Tae Suk

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N2 - Background Although previous studies have focused on determining prognostic and causative variables associated with fistula-related complications after head and neck reconstructive surgery, only a few studies have addressed preventive measures. Noting that pooled saliva complicates wound healing and precipitates fistula-related complications, we devised a continuous suction system to remove saliva during early postoperative recovery. Methods A continuous suction system was implemented in 20 patients after head and neck reconstructive surgery between January 2012 and October 2017. This group was compared to a control group of 16 patients at the same institution. The system was placed orally when the lesion was on the anterior side of the retromolar trigone area, and when glossectomy or resection of the mouth floor was performed. When the orohypopharynx and/or larynx were eradicated, the irrigation system was placed in the pharyngeal area. Results The mean follow-up period was 9.2 ±2.4 months. The Hemovac system was applied for an average of 7.5 days. On average, 6.5 days were needed for the net drain output to fall below 10 mL. Complications were analyzed according to their causes and rates. A fistula occurred in two cases in the suction group. Compared to the control group, a significant difference was noted in the surgical site infection rate (P<0.031). Conclusions Clinical observations showed reduced saliva pooling and a reduction in the infection rate. This resulted in improved wound healing through the application of a continuous suction system.

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