Two cases of postoperative pharyngocutaneous fistula treated with Negative Wound Pressure Therapy (NPWT)

Pharyngocutaneous fistula (PCF) is one of the most troublesome postoperative complications after head and neck cancer surgery, such as total laryngectomy, and especially in patients with previous radiotherapy, it takes longer to be completely cured. Generally, PCF is treated with adequate drainage, neck compression and frequent dressings. When spontaneous closure is not achieved with these conservative treatments, surgical closure with free or local flap is needed. In this report, we review two cases of postoperative PCF treated with Negative Pressure Wound Therapy (NPWT). NPWT is a relatively new method which is thought to promote healing of complicated wounds by utilizing topical negative pressure. Initially, there was concern that NPWT for PCF may promote salivary leak or air leak which would inhibit wound healing. However, in both of our cases, excellent wound healing was obtained and the fistula was successfully closed without surgical procedure. In addition to the effect of promoting healing, NPWT could save the time and effort of medical staff for performing frequent dressings. We consider that NPWT is a useful option for the treatment of postoperative PCFs.