Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
Ann Otol Rhinol Laryngol. 2023 Dec;132(12):1528-1534. doi: 10.1177/00034894231170582. Epub 2023 Apr 24.
To describe and evaluate the surgical outcomes of multilayered closure of persistent tracheocutaneous fistulae (TCF) in patients with challenged wound healing.
A retrospective chart review of all patients who underwent closure of TCF by the senior author between October 2011 and December 2021 was performed. Age, body mass index (BMI), time between decannulation and TCF repair, medical comorbidities, procedure duration, length of hospitalization, and postoperative complications were recorded. The primary outcomes were closure of the fistula, postoperative subcutaneous emphysema, pneumomediastinum, pneumothorax, wound infection, or breakdown. Outcomes of patients with and without challenged wound healing were compared.
Thirty-five patients who underwent TCF repair during the study period were identified. The mean age and BMI were 62.9 years and 28.43 respectively. Twenty-six (74%) patients met criteria for challenged wound healing at the time of the TCF repair. There was 1 (3.84%) minor complication in the challenged wound healing group and none (0%) in the control group ( = 1.00). No patients experienced wound breakdown or air leak noted on exam or chest radiography.
Multilayered closure of persistent tracheocutaneous fistulae is a simple technique which is safe and effective even in patients with challenged wound healing.
描述和评估在有创伤口愈合挑战的患者中，采用多层缝合方法治疗持续性气管切开瘘（TCF）的手术效果。
对 2011 年 10 月至 2021 年 12 月期间，由资深作者为所有 TCF 患者进行瘘口关闭手术的患者进行回顾性图表审查。记录年龄、体重指数（BMI）、气管切开与 TCF 修复之间的时间、并存的医学疾病、手术持续时间、住院时间和术后并发症。主要结局是瘘口关闭、术后皮下气肿、纵隔气肿、气胸、伤口感染或破裂。比较有创伤口愈合挑战和无创伤口愈合挑战患者的结果。
在研究期间，共确定了 35 名接受 TCF 修复的患者。平均年龄和 BMI 分别为 62.9 岁和 28.43。26 名（74%）患者在 TCF 修复时符合创伤口愈合挑战标准。在创伤口愈合挑战组中有 1 例（3.84%）轻微并发症，而在对照组中没有（0%）（ = 1.00）。没有患者在检查或胸部 X 线片上出现伤口破裂或空气泄漏。
即使在有创伤口愈合挑战的患者中，多层缝合治疗持续性气管切开瘘也是一种安全有效的简单技术。
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