A turnover de-epithelialised deltopectoral flap to close fistulae following antethoracic oesophageal reconstruction

Hinge Flap with Triangular Extension for Reconstruction of Pharyngocutaneous and Laryngocutaneous Fistulas

“…PCF is a common complication after surgical treatment of cervical malignancies, and there have been numerous reports about methods for closing these fistulas. 6 – 18 The hinge flap procedure, in which bilateral skin flaps raised alongside the PCF are turned in to line the pharynx, was described in a plastic surgery textbook published in 1948. 1 This procedure effectively augments the wall of the pharynx at the midsection of the reconstructed region, but stenosis and gaps can occur, especially at the caudal end of the flap due to circumferential contracture of the fistula that occurs while waiting for flap maturation.…”

Regenerative Medicine Strategies for Esophageal Repair

“…Advancements in surgical technique and instrumentation such as stents [21][22][23][24] have allowed for the development of techniques that are effective in restoring esophageal continuity and function. These strategies include omental wrapping of the esophagus, [25][26][27] gastric pull-up, [28][29][30][31][32] colonic and jejunal interpositions, [33][34][35] and deltopectoral [36][37][38] and pectoralis major [39][40][41][42] myocutaneous flaps. However, these techniques are still associated with significant complications and morbidity and, without exception, come at the expense of other anatomic structures.…”