Pharyngocutaneous
fistula is one of the fatal complications occurring after head and neck reconstruction with neck node dissection. Even minor salivary leakage from the
fistula could cause serious
infection and threaten the viability of the transferred flap or even lead to the
rupture of jugular vein. In such cases, proper management is difficult, and the chances for recurrence rise. We used a
collagen patch (
TachoComb) for
fistula prevention and treatment.
TachoComb, a
collagen patch integrated with activated
thrombin and
fibrinogen, was used to prevent postoperative
fistula formation in the initial reconstruction by applying them on sites with a high risk of salivary leakage. The patch was applied to 16 patients who had hypopharyngeal reconstruction, and the results were evaluated and compared with patients who had reconstruction without a
collagen patch. A
fistula occurred in 1 (6%) of 16 patients who received the
collagen patch, whereas it occurred in 6 (14%) of 43 patients who underwent reconstruction without the
collagen patch. In addition, the
collagen patch was also used to treat postoperative
fistula in 2 patients, and the results were successful after a single revision. Our results suggest that the
collagen patch can be effective in the prevention and treatment of postoperative
fistula after head and neck reconstruction, especially pharynx and cervical esophagus.