P203 PHARYNGOESOPHAGEAL RECONSTRUCTION AFTER LARYNGECTOMY AND RADIOTHERAPY

Aim The purpose of this presentation is to review our experience and evaluate our results in the treatment of patients with pharyngoesophageal fistula after laryngectomy and radiotherapy. Background & Methods 10 patients were examined at the head and neck combined oncology clinic after previous laryngectomy and radiotherapy and pharyngocutaneous fistula with weakness to feed food as well frequent aspiration pneumonia. The interval between the effect of the laryngectomy varies between 3-5 years depending on the severity of the symptomatology and after the complete failure of the conservative methods of reconstruction. Reconstruction was performed with musculocutaneous major pectoral flap in 8 patients, radial forearm flap and anterolateral thigh flap. Results The postoperative period was uncomplicated, and in all patients the feeding was held after barium swallow test, after 7-15 days with soft food. The gold standard treatment of pharyngoesophageal fistula after laryngectomy and radiotherapy is the musculocutaneous major pectoral flap and in severe radionecrosis of the neck with free tissue flap reconstruction. Conclusion Reconstruction with microsurgical techniques offer improved prognosis and quality of life of our patients.

Transplantation Treatment of Extensive Soft-Tissue Defects in Lower Extremities with a Combination of Cross-Bridge Flap and Combined Free-Tissue Flap Covered by Vacuum Sealing Drainage: One Case Report

This article reported the ultilization of cross-bridge flap transplantation and combined free-tissue flap transplantation to treat a 54-year-old male with Gustilo type III-C injuries. Thorough debridement, external fixation and vacuum sealing drainage were performed in the fist-stage treatment. After the removal of negative pressure on VSD devices, the joined free-tissue flaps and the cross-bridge flap were performed to repair the extensive soft-tissue defects. One month later the pedicle of cross-bridge flap was divided and the external fixator connecting both the lower legs was removed. In 3-month follow-up, the extensive defects was completely covered by a nearly normal skin and radiograph showed tibia and talus healing.

Validation of a Noninvasive Thermal Perfusion System Using a Canine Medial Saphenous Fasciocutaneous Free Tissue Flap Model

This work describes steps in the ongoing development of a system to noninvasively estimate blood perfusion using thermal methods. A combination thermocouple/thermopile sensor is used to record heat flux and temperature measurements on the tissue of interest. The resulting data are compared to a biothermal computer model to determine blood perfusion. The system has been tested on a canine medial saphenous fasciocutaneous free tissue flap that allows experimental control of blood flow to the measurement site. These experiments show distinct correlation between blood flow and bioprobe output demonstrating the validity of the measurement method.