Tian Brian, Khoo Deborah, Tay Ai Choo, Soo Khee-Chee, Tan Ngian Chye, Tan Hiang Khoon, Iyer N Gopalakrishna
Department of Surgical Oncology, National Cancer Centre Singapore, Singapore.
Head Neck. 2014 Jun;36(6):873-81. doi: 10.1002/hed.23393. Epub 2013 Sep 11.
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.
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.
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).
VAC therapy is an effective treatment option for orocutaneous fistulas.
负压封闭引流（VAC）系统已被用于处理复杂伤口。本研究的目的是描述一种使用VAC系统治疗口腔皮肤瘘的新技术。
对新加坡国立癌症中心治疗的10例术后发生口腔皮肤瘘的患者进行回顾性研究。水胶体牙科糊剂与VAC系统一起用作封闭瘘管的密封剂。我们使用RENASYS或VAC ATS系统，持续负压为50毫米汞柱至125毫米汞柱。
10例患者出现了11个瘘管。该队列患者的中位年龄为67岁（范围33 - 80岁）。9例患者通过VAC治疗成功封闭了瘘管，而1例患者VAC治疗失败，需要进行皮瓣重建。瘘管闭合的中位时间为19天（范围6 - 36天）。术后放疗的中位时间为46天（范围26 - 62天）。
VAC治疗是口腔皮肤瘘的一种有效治疗选择。
