Severe deep neck infections successfully treated with negative pressure wound therapy with instillation - a case report

Background: Deep neck infection (DNI) is a life-threatening complication associated with significant mortality and morbidity rates. The most common causes of DNI are the tonsilitis, dentitis, salivary glands inflammation, malignancies, and foreign bodies. As a result of neck infection, patients are at high risk of potential secondary complications which include: descending mediastinitis, pleural empyema, septicemia, jugular vein thrombosis, pericarditis. We presented a case of successful management of DNI with the utility of negative pressure wound therapy with instillation (iNPWT). Method: A 37-year-old male with deep neck infection due to dentitis was qualified for iNPWT. Due to previous incisions and drainage of the neck abscesses, some undermined wounds drained towards each other’s were revealed with an excessive amount of purulent content. Standard NPWT dressing was placed and polyurethane foam was covered with contact layer dressing. Additionally, an inflow drain was placed within one of the wounds in regard to instill an antimicrobial solution. The wound was instilled four times daily. Results: The patient underwent a total of eight iNWPT sessions. Locally, a reduction in purulent content was achieved with a decrease of wounds’ dimensions and improvement of wound bed granulation. Moreover, improvement of the patient’s general condition and decrease of inflammatory markers was achieved. Conclusions: iNPWT may play an important role in the management of combined, complicated wounds due to DNI. The instilled antimicrobial solution facilitates dissolving and removing of the purulent content that impairs the wound healing.

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Application of Negative Pressure Wound Therapy for Deep Neck Infection

Korean Journal of Otorhinolaryngology - Head and Neck Surgery ◽

10.3342/kjorl-hns.2016.59.2.125 ◽

2016 ◽

Vol 59 (2) ◽

pp. 125 ◽

Cited By ~ 1

Author(s):

Kyoung Ho Park ◽

Anna Park ◽

Changyun Kwon ◽

Young Sam Yoo ◽

Jeong Hwan Choi ◽

...

Keyword(s):

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Deep Neck Infection ◽

Wound Therapy ◽

Neck Infection

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A dangerous cause of airway obstruction: deep neck infection

10.22514/sv.2020.16.0101 ◽

2020 ◽

Keyword(s):

Airway Obstruction ◽

Upper Airway ◽

Deep Neck Infection ◽

Jugular Vein Thrombosis ◽

Neck Infection ◽

Vein Thrombosis ◽

Lethal Complications ◽

Life Threatening ◽

Fascial Spaces ◽

Emergency Doctors

Deep neck infection (DNI) is an infection in the fascial spaces of the neck. Complications of DNI, including mediastinitis, internal jugular vein thrombosis, and upper airway obstruction, are severe and potentially life threatening. Therefore, early identification and accurate management of DNI are essential. We review the anatomy of the deep spaces of the neck to determine the route of DNI spread so that emergency doctors, physicians, and otorhinolaryngologists can quickly recognize the development of lethal complications of DNI, such as asphyxia from airway obstruction.

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A Prospective Randomized Study: The Usefulness and Efficacy of Negative Pressure Wound Therapy with Lipidocolloid Polyester Mesh Compared to Traditional Negative Pressure Wound Therapy for Treatment of Pressure Ulcers

Pharmaceutics ◽

10.3390/pharmaceutics12090813 ◽

2020 ◽

Vol 12 (9) ◽

pp. 813

Author(s):

Wooyeol Baek ◽

Nara Lee ◽

Eun Jin Han ◽

Tai Suk Roh ◽

Won Jai Lee

Keyword(s):

Wound Healing ◽

Pressure Ulcer ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Randomized Study ◽

Contact Layer ◽

Control Group ◽

Wound Therapy ◽

Group 2 ◽

Group 1

To improve healing of pressure ulcer wounds, it is important to optimize the conditions of the area surrounding the wound. Negative pressure wound therapy (NPWT) promotes wound healing, however, the removal of NPWT can cause pain or focal bleeding, delaying wound healing or causing infection. In this study, we reviewed the efficacy of the lipidocolloid non-adherent dressing (Urgotul®) as a wound contact layer. A total of 38 patients from the same facility who applied NPWT from April 2016 to October 2019 were included and divided into two groups; NPWT with the lipidocolloid non-adherent dressing (group 1, experimental group, 19 patients) and NPWT only (group 2, control group, 19 patients). The condition of the wound was examined prior to NPWT application, at one week, and again at three weeks after application. No significant differences were found between groups for general characteristics, bacterial culture or photo analysis. However, when comparing groups based on the time of examination, there was a significant reduction of the wound size in group 1 (p = 0.001) but not in group 2 (p = 0.082). Therefore, the current study finds that using the lipidocolloid non-adherent dressing as a wound contact layer in NPWT stimulates healing by shrinking the size of the pressure ulcer wound.

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Evidence-based recommendations for negative pressure wound therapy: Treatment variables (pressure levels, wound filler and contact layer) – Steps towards an international consensus

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2011.06.001 ◽

2011 ◽

Vol 64 ◽

pp. S1-S16 ◽

Cited By ~ 83

Author(s):

H. Birke-Sorensen ◽

M. Malmsjo ◽

P. Rome ◽

D. Hudson ◽

E. Krug ◽

...

Keyword(s):

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Contact Layer ◽

Evidence Based ◽

Wound Therapy ◽

International Consensus ◽

Therapy Treatment

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Internal Jugular Vein Thrombosis and Deep Neck Infection from Intravenous Drug Use: Management Strategy

The Laryngoscope ◽

10.1097/00005537-200401000-00009 ◽

2004 ◽

Vol 114 (1) ◽

pp. 56-60 ◽

Cited By ~ 27

Author(s):

Doris Lin ◽

Jay B. Reeck ◽

Andrew H. Murr

Keyword(s):

Drug Use ◽

Internal Jugular Vein ◽

Management Strategy ◽

Jugular Vein ◽

Deep Neck Infection ◽

Intravenous Drug Use ◽

Jugular Vein Thrombosis ◽

Neck Infection ◽

Vein Thrombosis ◽

Internal Jugular Vein Thrombosis

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Prospective Assessment of the Negative Pressure Wound Therapy of the Open Abdomen

Negative Pressure Wound Therapy Journal ◽

10.18487/npwtj.v3i2.19 ◽

2016 ◽

Vol 3 (2) ◽

Author(s):

Martin Hutan ◽

Christian Bartko ◽

Augustin Prochotsky ◽

Jaroslav Sekac ◽

Jan Skultety ◽

...

Keyword(s):

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Open Abdomen ◽

Fascial Closure ◽

High Morbidity ◽

Temporary Abdominal Closure ◽

Wound Therapy ◽

Mortality And Morbidity ◽

Prospective Assessment ◽

Sequential Closure

Open abdomen (OA) is a surgical approach, that emerged in last 15 years, with its management being complicated, timely and financially demanding, burdened with high morbidity and mortality. In recent years, several publications proved superiority of usage of negative pressure wound therapy (NPWT) over usage of conventional temporary abdominal closure techniques in treatment of open abdomen. Different aspects of treatment of OA with NPWT remain to be assessed and stated.Authors of the paper prospectively assessed group of 48 patients with OA, managed by one surgeon with NPWT between 2006-2014, assessing mortality and morbidity in the group stratified by indication for OA, type of sequential closure of OA, presence and management of concomitant enteroatmospheric fistula (EAF), maximal values of C-reactive protein (CRP) and Procalcitonine (PCT), and initial body mass index (BMI). Mortality of the whole group was 35.41%, rate of fascial closure 45.83% and rate of the wound closure 83.33%. Incidence of the fistula was 37.5%, of these 66.67% were successfully locally managed. Incidence of fascial closure without use of sequential closure was significantly lower as opposed to use of different techniques of sequential closure.Unsuccessful local management of EAF is significant predictor of mortality. All other data were not found to be statistically significant. Identifying specific aspects of treatment of OA by NPWT, significantly improving outcomes, and adhering to these aspects in clinical practice will further ameliorate outcomes.

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Negative Pressure Wound Therapy Using Polyurethane Foam in a Patient with Necrotizing Fasciitis

Materiale Plastice ◽

10.37358/mp.18.4.5083 ◽

2018 ◽

Vol 55 (4) ◽

pp. 603-605 ◽

Cited By ~ 2

Author(s):

Adelaida Avino ◽

Cristian Radu Jecan ◽

Cristina Nicoleta Cozma ◽

Andra Elena Balcangiu Stroescu ◽

Daniela Gabriela Balan ◽

...

Keyword(s):

Necrotizing Fasciitis ◽

Polyurethane Foam ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Skin Grafting ◽

Wound Therapy ◽

Vein Thrombosis ◽

History Of ◽

Deep Vein

Negative pressure wound therapy is one of the newest methods of treatment used in wound healing. An important role of the system has a foam dressing that connects the wound with the vacuum. In general the sponge used in vacuum assisted therapies is made of polyurethane foam. We present the case of a 51-year-old male patient with a history of deep vein thrombosis (known for about 3 years) diagnosed with necrotizing fasciitis (NF). In this patient, after each step of the surgical treatment (large debridement and skin grafting) negative pressure wound therapy using polyurethane foam was used.

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