Korean J Otorhinolaryngol-Head Neck Surg.  2016 Feb;59(2):125-132. 10.3342/kjorl-hns.2016.59.2.125.

Application of Negative Pressure Wound Therapy for Deep Neck Infection

• Park KH
• Park A
• Kwon C
• Yoo YS
• Choi JH
• Cho KR
• Chung ES

• KMID: 2155059
• DOI: http://doi.org/10.3342/kjorl-hns.2016.59.2.125

Abstract

BACKGROUND AND OBJECTIVES
Negative Pressure Wound Therapy (NPWT) has been used in many surgery to treat complicated wound and impaired wound healing by delivering negative pressure at the wound site through a patented dressing, which helps draw wound edges together, remove infectious materials, and actively promote granulation at the cellular level. Recently application of NPWT has been increased to treat deep neck infection. We aimed to retrieve indications and guidelines to treat deep neck infection from our cases and after reviewing articles.
SUBJECTS AND METHOD
From our experience with 9 cases presented as deep neck abscess in which the application of a Vacuum-assisted closure device was used instead of common drainage tubes after surgical evacuation and journal review, indications and guidelines to apply NPWT as one of the tools to treat deep neck infection were retrieved.
RESULTS
Indication and Guideline of NPWT. 1) For simple abscess involving single space excepting the mediastinum, intravenous administration of broad-spectrum antibiotics, needle aspiration or simple surgical drainage is recommended. 2) In the case of failure of previous treatments, NPWT will be necessary for immunocompromised hosts such as diabetic patients for whom more than two spaces are involved, the mediastinal involvement, compromised airway or disseminated intravascular coagulation. In severe cases involving the chest, video-assisted thoracoscopic surgery or mediastinoscopy could be used. 3) For patients with improving signs such as decreasing pus, increasing granulation formation, negative culture results from sponge, and normalized C-reactive protein, we can stop NPWT and convert to the regular wound care.
CONCLUSION
Indication and Guideline of NPWT could be applied to treat deep neck infection.

Keyword

Deep neck infection; Negative pressure wound therapy

MeSH Terms

Abscess
Administration, Intravenous
Anti-Bacterial Agents
Bandages
C-Reactive Protein
Disseminated Intravascular Coagulation
Drainage
Humans
Immunocompromised Host
Mediastinoscopy
Mediastinum
Neck*
Needles
Negative-Pressure Wound Therapy*
Porifera
Suppuration
Thoracic Surgery, Video-Assisted
Thorax
Wound Healing
Wounds and Injuries
Anti-Bacterial Agents
C-Reactive Protein