Abstract

CLOSURE OF RECALCITRANT TRACHEOCUTANEOUS FISTULA-BY USING TURN OVER PLATYSMAL MUSCLE FLAPS

Author(s): Dr. Nikhil B. Kunjir,

ABSTRACT BACKGROUND The objective of the study was to determine efficacy of repair of recalcitrant tracheocutaneous fistula with the use of medial based turnover platysma muscle flaps; providing a double layer covering to the fistula with a cosmetic scar. MATERIALS AND METHODS This was a prospective study carried out in a Sassoon Government hospital on 10 patients who came with the complaint of a stomal opening in neck after prolonged tracheostomy. Persistent air leak through the stoma causes hampered vocalisation, coughing etc. In this series of ten cases we used platysma muscle turnover flaps to provide a strengthened anterior wall for the fistula. The cases were then regularly followed up for results and complications. RESULTS This method provides a relatively easy way to repair the soft tissue defect over the trachea and revise tracheocutaneous fistula. Ten Patients (4 male and 6 female) with average age of 32 yrs. with recalcitrant tracheocutaneous fistula seen at the SGH, Pune between Sept. 2016 to Aug. 2017, underwent repair using medially based turnover platysmal muscle flap. It provides adequate bulk without tension and should be employed for repairing fistulae as well. The postoperative complications include subcutaneous emphysema and wound infection in 2 out of 10 patients. CONCLUSION Medially-based turnover platysma muscle flaps can be used to repair recalcitrant tracheocutaneous fistulae by providing a double-layer covering to the fistula with a cosmetic scar.