Management of post-operative fistula in head and neck surgery: Sweeping it under the carpet?

Figure 1 Negative pressure wound therapy dressing applied at a challenging location for a peristomal fistula using a combination of hydrogum dental paste and medical silicone. A: A parastomal fistula in a patient with a hypopharyngeal SCC status post pharyngolaryngectomy with Provox prosthesis, bilateral modified radical neck dissection, end tracheostomy, and pectoralis major flap; B: A negative pressure wound therapy (NWPT) dressing applied over the parastomal fistula using medical silicone and dental pasting (not shown); C: Wound inspection of fistula after 1 wk of NWPT shows improved granulating tissue. Patient also reported improved quality of life with the fistula being properly drained with little to no odor.