Complication in the pharyngeal cutaneous fistula after total laryngectomy: a preliminary analysis

Abstract

The most severe and frequent complication presented by laryngectomized patients is the pharyngeal cutaneous fistula. This investigation aimed at analyzing the frequency in the literature of the risk factors that contribute to the formation of pharyngeal cutaneous fistula. This is a descriptive study in which authors analyzed 10 articles, indexed in the PUBMED and MEDLINE databases from March 2001 to March 2002. The risk factors for the formation of pharyngeal cutaneous fistula were: preoperatory radiotherapy; neck dissection, type of material used for sutura; preoperatory tracheostomy; systemic diseases; blood transfusion; neck draining type; infection and hematoma formation. This complication increases the hospitalization and cicatrization period, with an average of 28 days and 36 days, respectively. The predominant treatment is still conservative, in which the nurse needs technical and scientific knowledge as the care involves intensive and hygienic procedures and the wound treatment. The ability for clinical and technical reasoning linked to the search for evidences as well as nurse's capability of interpersonal relationship will determine the quality of nursing interventions in the care provided to the laryngectomized patient.