Modified Usage of Negative Pressure Wound Therapy for the Management of Severe Deep Fascial Space Infections in the Head and Neck

• Main Authors: Cao J, Liu Z, Ma D, Shen S, Wang X
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-03-01
• Series: Infection and Drug Resistance
• Subjects: negative pressure wound therapy; severe deep fascial space infections; modified usage; head and neck
• Online Access: https://www.dovepress.com/modified-usage-of-negative-pressure-wound-therapy-for-the-management-o-peer-reviewed-article-IDR

Jian Cao,1,2,* Zhixu Liu,1,* Dongyang Ma,2 Shunyao Shen,1 Xudong Wang1 1Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, People’s Republic of China; 2Department of Oral and Maxillofacial Surgery, The 940th Hospital of People’s Liberation Army, Lanzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xudong WangDepartment of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai 200011, People’s Republic of ChinaTel [phone]Email [e-mail]: Although negative pressure wound therapy (NPWT) has been widely used in complicated wound care, there are still some obstacles regarding its use in the treatment of severe deep fascial space infections in the head and neck. The purpose of this study is to describe a new modified usage of NPWT and investigate the clinical efficacy of this system in a consecutive case series of severe deep fascial space infections.Methods: The investigators implemented a new modification of NPWT for the management of severe deep fascial space infections. In this new system, the half-plugged bar-shaped foam material was arranged along with the through-and-through side-holed latex drainage tube, which could maintain negative pressure in the distal part of the spaces, and the tube was easy to remove 5– 7 days after surgery. Twelve patients had severe deep fascial space infections in the head and neck with a direct threat to the airway. The median time of removal of the NPWT device, the median amount of drainage fluid and the median healing time were investigated.Results: A total of 7 male and 5 female patients with an average age of 63.2 years old were included in this study. The median time of removal of the NPWT device was 6 days (ranging from 4 to 7 days). The median amount of drainage fluid within 3 days after surgery was 420 mL (ranging from 280– 760 mL), and the median time for complete wound healing was 12 days (ranging from 10 to 21 days).Conclusion: The results of this study suggest that the modification of NPWT provides various advantages and leads to excellent clinical outcomes in the treatment of severe deep fascial space infections. Future studies will focus on the safety verification of portable usage and the cost effectiveness analysis of NPWT.Keywords: negative pressure wound therapy, severe deep fascial space infections, modified usage, head and neck