Use of Latissimus Dorsi Myocutaneous Island Flap for Pharyngeal Reconstruction in Setting of Postoperative Wound Infection in Salvage Laryngectomy

Salvage laryngectomy frequently associated with more postoperative complication as compared with primary total laryngectomy. It carries a high risk of postoperative infection with reported rates of 40–61%. Problem related to local wound healing, especially development of pharyngo-cutaneous fistula constitutes the most common postoperative complication in these patients. In setting of treatment failure and gross extra laryngeal disease with fungating wound with infection, the situation even get worse while considering patient for salvage total laryngectomy. Postradiotherapy, poor blood supply of skin in irradiated portion adds extra pinch of salt in poor wound healing. We are here reporting case of management of salvage laryngectomy patient who had severe postoperative infection causing series of flap loss and pharyngeal leak in setting of preoperative gross extra laryngeal disease with skin involvement. In the present article, we were able to manage the case with PMMC and latissimus dorsi myocutaneous flaps.