Shu-Jun Chen1, Yu-Xuan Chen2, Jian-Rui Xiao3, Xiao-Zong Wei4, Shuang-Min Chen3, Wang-Zhan Jiang5. 1. Deputy Director, Department of Oral and Maxillofacial Surgery, 252nd Hospital of the People's Liberation Army of China, Baoding, China. Electronic address: shujunchen001@gmail.com. 2. Department Head, Department of Oral and Maxillofacial Surgery, 252nd Hospital of the People's Liberation Army of China, Baoding, China. 3. Attending Doctor, Department of Oral and Maxillofacial Surgery, 252nd Hospital of the People's Liberation Army of China, Baoding, China. 4. Chief Resident, Department of Oral and Maxillofacial Surgery, 252nd Hospital of the People's Liberation Army of China, Baoding, China. 5. Resident, Department of Oral and Maxillofacial Surgery, 252nd Hospital of the People's Liberation Army of China, Baoding, China.
Abstract
PURPOSE: Necrotizing fasciitis is a severe soft tissue infection that is uncommon in the head and neck region. Despite the advancement of care over the past few decades, the mortality rate remains high. Negative pressure wound therapy (NPWT), an advanced wound-healing technique, has become increasingly popular for a wide variety of complicated wounds. Since December 2015, we have used this technique in the management of necrotizing fasciitis of the head and neck. We report a consecutive case series treated with NPWT as the initial surgical procedure. MATERIALS AND METHODS: Seven patients who received a surgical diagnosis of necrotizing fasciitis of the head and neck underwent surgery under general anesthesia. After complete debridement, an NPWT device was applied for positive drainage of the involved areas. The drainage tube was connected to a central negative pressure system. The device was not replaced or removed until the infection was controlled. Then, a conventional drainage approach was used. RESULTS: Of the 7 patients, 6 underwent the surgical procedure and NPWT once; the remaining patient underwent these procedures twice. The infectious cavities showed a clean wound covered with healthy granulation formation during the removal of the NPWT device. The following course was uneventful. The mean time for wound healing was 17.3 ± 6.1 days. CONCLUSIONS: NPWT provides various advantages compared with conventional debridement and drainage, resulting in excellent clinical outcomes. This method could be recommended as an alternative approach in the management of necrotizing fasciitis in the head and neck region.
PURPOSE:Necrotizing fasciitis is a severe soft tissue infection that is uncommon in the head and neck region. Despite the advancement of care over the past few decades, the mortality rate remains high. Negative pressure wound therapy (NPWT), an advanced wound-healing technique, has become increasingly popular for a wide variety of complicated wounds. Since December 2015, we have used this technique in the management of necrotizing fasciitis of the head and neck. We report a consecutive case series treated with NPWT as the initial surgical procedure. MATERIALS AND METHODS: Seven patients who received a surgical diagnosis of necrotizing fasciitis of the head and neck underwent surgery under general anesthesia. After complete debridement, an NPWT device was applied for positive drainage of the involved areas. The drainage tube was connected to a central negative pressure system. The device was not replaced or removed until the infection was controlled. Then, a conventional drainage approach was used. RESULTS: Of the 7 patients, 6 underwent the surgical procedure and NPWT once; the remaining patient underwent these procedures twice. The infectious cavities showed a clean wound covered with healthy granulation formation during the removal of the NPWT device. The following course was uneventful. The mean time for wound healing was 17.3 ± 6.1 days. CONCLUSIONS: NPWT provides various advantages compared with conventional debridement and drainage, resulting in excellent clinical outcomes. This method could be recommended as an alternative approach in the management of necrotizing fasciitis in the head and neck region.
Authors: Nicholas A Rapoport; David S Lee; Jake J Lee; Sidharth V Puram; Ryan S Jackson; Patrik Pipkorn Journal: Ann Otol Rhinol Laryngol Date: 2022-04-02 Impact factor: 1.973
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