Early detection and treatment of postoperative pharyngocutaneous fistula

Otolaryngol Head Neck Surg. 1999 Oct;121(4):378-80. doi: 10.1016/S0194-5998(99)70224-X.

Abstract

Fever during the early postoperative period traditionally has not been considered an indication of a postoperative wound infection or breakdown. Atelectasis is considered the most likely source for these early fevers. We studied 200 consecutive patients who underwent major head and neck surgery that involved reconstruction with a pharyngeal suture line. Patients were divided into 2 groups: those who had preoperative irradiation and those who did not. All patients had prophylactic antibiotic coverage, and all patients had identical suture material for closure. We showed a high correlation between fever (>101.5 degrees F) that developed in the first 48 hours and eventual fistula formation and wound infection. We also studied length of hospitalization and number of days until decannulation and resumption of oral feedings. Our data indicate that in those patients in whom fistulas developed, early detection led to earlier healing and rehabilitation.

Publication types

  • Comparative Study

MeSH terms

  • Antibiotic Prophylaxis
  • Cutaneous Fistula / diagnosis
  • Cutaneous Fistula / surgery*
  • Fever of Unknown Origin / etiology
  • Fistula / diagnosis
  • Fistula / surgery*
  • Humans
  • Length of Stay
  • Otorhinolaryngologic Neoplasms / radiotherapy
  • Otorhinolaryngologic Neoplasms / surgery*
  • Pharyngeal Diseases / diagnosis
  • Pharyngeal Diseases / surgery*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / surgery*
  • Retrospective Studies
  • Risk Factors
  • Surgical Flaps
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / surgery
  • Suture Techniques
  • Wound Healing / physiology