Dermal Graft for Protection of the Pharyngeal Suture Line in Cancer Surgery of the Head and Neck

We studied the effect of free buried dermal grafts to primary pharyngeal closures among 24 nonirradiated patients undergoing radical head and neck surgery to determine if this technique would reduce the incidence of postoperative pharyngocutaneous fistula. For a control group we selected 23 patients who had undergone similar operations as the patients in the study group, but who did not have dermis used for pharyngeal protection. Our results indicate that dermal grafts do not alter the incidence of fistulization following cancer surgery of the head and neck.

Download Full-text

Utility of negative‐pressure wound therapy for orocutaneous and pharyngocutaneous fistula following head and neck surgery

Head & Neck ◽

10.1002/hed.25989 ◽

2019 ◽

Vol 42 (1) ◽

pp. 103-110 ◽

Cited By ~ 1

Author(s):

Yusuke Inatomi ◽

Hideki Kadota ◽

Sei Yoshida ◽

Kenichi Kamizono ◽

Ryo Shimamoto ◽

...

Keyword(s):

Head And Neck ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Pharyngocutaneous Fistula ◽

Wound Therapy

Download Full-text

Prophylaxis for venous thromboembolism in head and neck surgery: the practice of otolaryngologists

The Journal of Laryngology & Otology ◽

10.1017/s0022215100138770 ◽

1997 ◽

Vol 111 (9) ◽

pp. 845-849 ◽

Cited By ~ 14

Author(s):

K. W. Ah-See ◽

J. Kerr ◽

D. W. Sim

Keyword(s):

Head And Neck Cancer ◽

Venous Thromboembolism ◽

Head And Neck ◽

Neck Cancer ◽

Neck Surgery ◽

Cancer Surgery ◽

Head And Neck Surgery ◽

Surgical Patient ◽

Thromboembolism Prophylaxis ◽

Dvt Prophylaxis

AbstractDeep venous thrombosis (DVT) and pulmonary embolism (PE) are an important cause of morbidity and mortality in the surgical patient. The first guideline produced by the Scottish Intercollegiate Guidelines Network was for the prophylaxis of venous thromboembolism. Patients undergoing major head and neck cancer surgery commonly exhibit risk factors for venous thromboembolism. Currently, however, there are no data on its incidence in these patients. A questionnaire survey was performed to assess the current practice of consultant otolaryngologists regarding DVT prophylaxis in patients undergoing head and neck cancer surgery. Of those respondents who managed these patients, 57 per cent did not use routine DVT prophylaxis while 43 per cent did. A wide variety of techniques were employed among those practising DVT prophylaxis.A consensus is needed concerning the use of thromboembolism prophylaxis in head and neck surgery patients.

Download Full-text

Safety trial of Floseal® haemostatic agent in head and neck surgery

Annals of The Royal College of Surgeons of England ◽

10.1308/003588412x13171221590971 ◽

2012 ◽

Vol 94 (5) ◽

pp. 336-339 ◽

Cited By ~ 19

Author(s):

A Ujam ◽

Z Awad ◽

G Wong ◽

T Tatla ◽

R Farrell

Keyword(s):

Blood Loss ◽

Allergic Reaction ◽

Hospital Stay ◽

Head And Neck ◽

Prospective Trial ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Secondary Outcome ◽

Control Group ◽

Haematoma Formation

INTRODUCTION Floseal® (Baxter, Hayward, CA, US) can be of value in reducing blood loss and haematoma rates. The manufacturer’s warnings include allergic reaction, poor wound healing and intravascular thrombosis. We aimed to determine whether Floseal® is safe to use in various head and neck surgery (HNS) procedures. METHODS A prospective trial was conducted using Floseal® in 42 various consecutive head and neck surgery procedures. Adverse incidents were used as the main outcome measure, including allergic reaction, wound breakdown, wound infection and thrombosis. Secondary outcome measures included haematoma formation, hospital stay, drain times and output. RESULTS No adverse incidents were recorded in the trial period. Two patients developed haematomas and required surgical exploration where a bleeding vessel was identified and dealt with. CONCLUSIONS Floseal® is safe to be used in head and neck surgery with no adverse effects. A larger number and a control group are required to ascertain its value in reducing blood loss, haematoma formation, drain usage and hospital stay.

Download Full-text

Functional requirements for polymeric implant materials in head and neck surgery

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-209212 ◽

2020 ◽

Vol 76 (2) ◽

pp. 179-189

Author(s):

Dorothee Rickert ◽

Helmut Steinhart ◽

Andreas Lendlein

Keyword(s):

Head And Neck ◽

Gastric Wall ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Application Site ◽

Control Group ◽

Worst Case ◽

Implant Materials ◽

Systemic Responses ◽

Pharyngeal Reconstruction

BACKGROUND: The pharyngeal reconstruction is a challenging aspect after pharyngeal tumor resection. The pharyngeal passage has to be restored to enable oral alimentation and speech rehabilitation. Several techniques like local transposition of skin, mucosa and/or muscle, regional flaps and free vascularized flaps have been developed to reconstruct pharyngeal defects following surgery, in order to restore function and aesthetics. The reconstruction of the pharynx by degradable, multifunctional polymeric materials would be a novel therapeutical option in head and neck surgery. MATERIALS AND METHODS: Samples of an ethylene-oxide sterilized polymer (diameter 10 mm, 200μm thick) were implanted for the reconstruction of a standardized defect of the gastric wall in rats in a prospective study. The stomach is a model for a “worst case” application site to test the stability of the implant material under extreme chemical, enzymatical, bacterial, and mechanical load. RESULTS: Fundamental parameters investigated in this animal model were a local tight closure between the polymer and surrounding tissues, histological findings of tissue regeneration and systemic responses to inflammation. A tight anastomosis between the polymer and the adjacent stomach wall was found in all animals after polymer implantation (n = 42). Histologically, a regeneration with glandular epithelium was found in the polymer group. No differences in the systemic responses to inflammation were found between the polymer group (n = 42) and the control group (n = 21) with primary wound closure of the defect of the gastric wall. CONCLUSIONS: A sufficient stability of the polymeric material is a requirement for the pharyngeal reconstruction with implant materials.

Download Full-text