Can tissue adhesives and platelet-rich plasma prevent pharyngocutaneous fistula formation?

Eryılmaz, Adil; Demirci, Buket; Günel, Ceren; Doger, Firuzan Kacar; Yukselen, Ozden; Ömürlü, İmran Kurt; Başal, Yeşim; Ağdaş, Fatih; Başak, Sema

doi:10.1016/j.anl.2015.06.012

Cited by 17 publications

(18 citation statements)

References 37 publications

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“…12,22 A tissue adhesive used in the upper gastrointestinal tract needs to have properties suitable for use in a wet environment (blood and gastrointestinal secretions). 8 There was no statistical difference in pharyngeal fistula rate; however, the small size of the group numbers was acknowledged. For a sealant to be fully effective, it should cover the entire repair, acting as a second barrier to fistula formation.…”

Section: Resultsmentioning

confidence: 92%

“…An animal study compared the use of 3 tissue glues (a fibrin adhesive, a synthetic adhesive, and a protein-based albumin glutaraldehyde adhesive) and platelet-rich plasma applied over a sutured pharyngotomy with a control group (suture repair only). 8 There was no statistical difference in pharyngeal fistula rate; however, the small size of the group numbers was acknowledged. The pharyngeal suture line was also histopathologically evaluated; inflammatory infiltration was higher in the platelet-rich plasma group and fibroblastic activity was greater in all of the intervention groups than in the control group.…”

Section: Discussionmentioning

confidence: 92%

“…4 Pharyngocutaneous fistula is associated with a significantly increased duration of hospital stay and readmission. [8][9][10] The use of sealants has also become increasingly widespread across the surgical specialities, including otorhinolaryngology, and reported applications include closure of an established pharyngocutaneous fistula and of iatrogenic upper digestive tract perforations. As pharyngocutaneous fistula is the principal short-term complication to be avoided, much focus has been placed on evaluation of risk factors for pharyngocutaneous fistula development and associated preventative measures.…”

Section: Introductionmentioning

confidence: 99%

“…The use of surgical sealants or "glues" in pharyngoesophageal repairs has, however, been explored in animal studies. [8][9][10] The use of sealants has also become increasingly widespread across the surgical specialities, including otorhinolaryngology, and reported applications include closure of an established pharyngocutaneous fistula and of iatrogenic upper digestive tract perforations. [11][12][13] 2 | MATERIALS AND METHODS…”

Section: Introductionmentioning

confidence: 99%

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Use of surgical sealant in the prevention of pharyngocutaneous fistula after total laryngectomy

et al. 2018

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Background Pharyngocutaneous fistula is a major wound complication of total laryngectomy. Surgical sealants may be used to increase the strength and/or integrity of surgical repairs. The purpose of this study was to present our evaluation of the feasibility and utility of the application of sealant to the pharyngeal repair with the aim of reducing pharyngocutaneous fistula incidence. Methods This was a prospective single‐blind randomized controlled study; patients undergoing primary total laryngectomy for advanced carcinoma of the larynx were randomized into control and treatment (albumin‐polyaldehyde sealant applied to pharyngeal repair) groups. Relevant patient, disease, and management‐related factors were recorded. Results Forty‐five patients were included (23 controls and 22 who received treatments). No difference in the incidence of pharyngocutaneous fistula was observed between the 2 groups. No treatment‐related complications occurred. Conclusion Feasibility of application of an albumin‐polyaldehyde surgical sealant to the pharyngeal repair was demonstrated, however, a pharyngocutaneous fistula‐preventative effect was not observed. Larger animal and clinical studies are encouraged to clarify this finding.

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Section: Resultsmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Use of surgical sealant in the prevention of pharyngocutaneous fistula after total laryngectomy

et al. 2018

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“…The importance of our results is only fully appreciated when compared to published rates (Table 2), [8][9][10][11][12] as this is a correlating marker to assess for any reduction in the incidence of pharyngocutaneous fistula. In our case series, the overall fistula rate was only 6 per cent.…”

Section: Discussionmentioning

confidence: 99%

Reducing the rate of fistula: does a fibrin sealant act as an adjunct in pharyngeal closure? A two-centre experience

et al. 2020

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Background Pharyngocutaneous fistula is a troublesome complication. Recently, synthetic materials such as fibrin sealant have been used as a secondary measure to treat fistula. This work assessed whether the primary use of fibrin sealant can reduce the rate of fistula. Method A retrospective review of 50 cases from 2 centres was completed. Tisseel was an adjunct to primary closure in all cases. Results In the first centre, 3 out of 34 cases developed pharyngocutaneous fistula (fistula rate of 9 per cent). All three were salvage cases. In the second centre, 0 out of 16 cases developed a fistula. Conclusion The incidence of pharyngocutaneous fistula post-radiation and post-chemoradiotherapy in laryngectomy cases has been quoted as 23 per cent and 34 per cent respectively. This study represents the first patient series on the use of fibrin sealant as an adjunct in primary closure following laryngectomy. The results are promising, encouraging the use of Tisseel as an adjunct to meticulous closure.

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Effectiveness of Platelet‐Rich Plasma for COVID‐19‐Related Olfactory Dysfunction: A Controlled Study

Lechien

Saussez

Vaira

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveTo investigate the effectiveness of platelet‐rich plasma (PRP) injection into the olfactory clefts of coronavirus disease 2019 (COVID‐19) patients with persistent olfactory dysfunction (OD).Study DesignControlled study.SettingMulticenter study.MethodsFrom March 2022 to November 2022, COVID‐19 patients with persistent OD were recruited from three European hospitals to undergo PRP injections into the olfactory clefts. Olfactory function was evaluated at baseline and 10 weeks postinjection with the Olfactory Disorder Questionnaire (ODQ) and threshold, discrimination, and identification (TDI) test. Data were compared with a control group of untreated patients.ResultsEighty‐one patients who underwent PRP injection and 78 controls were included. Sixty‐five PRP patients (80.3%) experienced subjective smell improvement after a mean duration of 3.4 ± 1.9 weeks. The parosmia, life quality statement, and ODQ sub‐ and total scores significantly decreased from pre‐ to 10‐week postinjection in the PRP group. The TDI sub‐ and total scores significantly increased 10 weeks postinjection. In controls, the ODQ score did not change over time, while the discrimination, identification, and total TDI scores significantly increase after 10 weeks of follow‐up. The 10‐week TDI and ODQ scores were significantly better in the PRP group compared with the controls.ConclusionPatients who underwent PRP injection reported better 10‐week subjective and objective smell outcomes than controls. Future randomized‐controlled studies using saline injection into the olfactory cleft of controls are needed to determine the superiority of PRP over placebo.

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Can tissue adhesives and platelet-rich plasma prevent pharyngocutaneous fistula formation?

Cited by 17 publications

References 37 publications

Use of surgical sealant in the prevention of pharyngocutaneous fistula after total laryngectomy

Use of surgical sealant in the prevention of pharyngocutaneous fistula after total laryngectomy

Reducing the rate of fistula: does a fibrin sealant act as an adjunct in pharyngeal closure? A two-centre experience

Effectiveness of Platelet‐Rich Plasma for COVID‐19‐Related Olfactory Dysfunction: A Controlled Study

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