Elaboración de un protocolo para el manejo de la herida quirúrgica en cirugía de cabeza y cuello: una cura eficaz, efectiva y eficiente en pacientes laringectomizados

Abstract

Introduction: Surgical wound healing is an essential factor for the head and neck patient in the postoperative period. A short and uncomplicated healing improves overall condition, and limits hospital stay and medical costs. A protocol for patients undergoing head and neck surgery consisting of preparation of the surgical wound as moist wound healing technique was introduced in our department in 2005. Results: 169 patients were analyzed: 131 from group 1 and 38 from group 2. More than 94% of patients were male, mean age 60 years in group 1 and 68 years in group 2. Pharyngostoma formation was significantly higher in group 1 (42.9% vs 26.1%), especially in patients who had received prior radiotherapy. Hospital stay average was slightly higher in patients from group 1. Material and Methods: Data from patients undergoing total laryngectomy and horizontal supraglottic laryngectomy were analyzed, from 1995 to 2005 (group 1), and from 2005 to 2011 (group 2), in order to assess the hospital stay average, and pharyngocutaneous fistula formation before and after the introduction of the protocol of moist wound healing (MWH). Conclusion: Reduction in hospital stay average and decreased formation of pharyngostoma is easily attributable to the use of the protocol of MWH, thus saving healthcare costs and improving the patient quality of life.