Negative Pressure Wound Therapy (Wound VAC) in the Treatment of Chylous Fistula After Neck Dissection.

OBJECTIVES: Cervical chylous fistula is an uncommon but potentially severe occurrence associated with neck surgery. Methods for treating this problem have inconsistent efficacy and may result in lengthy hospital stays. Negative pressure wound therapy (NPWT) is a highly effective tool in the management of complex wounds. We report 3 cases where NPWT was successfully used to treat chylous fistulas following neck dissection.

METHODS: This is a retrospective chart review of 3 patients who developed chylous fistulas after neck dissection and were successfully treated with NPWT.

RESULTS: Chylous ouput ceased within 2 to 8 days of proper wound VAC placement. Hospital stays ranged from 6 to 47 days. Patients received altered diets, including TPN for 1 patient with high-flow output and nil-per-os (NPO) or clear liquids for the others. Patients received octreotide throughout their hospitalization.

CONCLUSION: NPWT shows potential as a treatment option for both high-volume and low-volume chylous fistulas following neck dissection.