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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  ;  Yoon Woo Koh  ;  Se-Heon Kim  ;  Dae Hyun Lew  ;  Tae Suk Roh 
 Archives of Plastic Surgery, Vol.45(5) : 449-457, 2018 
Journal Title
 Archives of Plastic Surgery 
Issue Date
Fistula ; Infection ; Saliva ; Suction
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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1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Seok(김영석) ORCID logo https://orcid.org/0000-0002-0981-2107
Roh, Tai Suk(노태석) ORCID logo https://orcid.org/0000-0001-8681-159X
Lew, Dae Hyun(유대현)
Lee, Won Jai(이원재) ORCID logo https://orcid.org/0000-0003-3056-0503
Hong, Jong Won(홍종원) ORCID logo https://orcid.org/0000-0002-7762-0940
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