Use of negative pressure wound therapy with instillation in the management of cervical necrotizing fasciitis

Head Neck. 2015 Nov;37(11):E157-60. doi: 10.1002/hed.24028. Epub 2015 Aug 6.

Abstract

Background: Cervical necrotizing fasciitis is an aggressive infection that can be rapidly fatal if aggressive therapies are not initiated early. Negative pressure wound therapy has been established as an effective tool in promoting wound healing, but its use in the acutely infected wound has been avoided because it limits frequent irrigations and standard dressing changes.

Methods: We discuss a novel application of negative pressure wound therapy with instillation in an immunocompromised patient with extensive cervical necrotizing fasciitis.

Results: The negative pressure wound therapy with instillation provided pain relief by minimizing the frequency of dressing changes, increased the speed of healing, helped to control infection, and facilitated the development of a healthy wound bed sufficient for reconstruction with a split thickness skin graft.

Conclusion: The role of negative pressure wound therapy with instillation continues to expand and can be used in the management of both acute and chronic wounds in the head and neck.

Keywords: cervical; instillation; necrotizing fasciitis; negative pressure therapy; wound vacuum therapy.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Debridement / methods
  • Fasciitis, Necrotizing / diagnosis*
  • Fasciitis, Necrotizing / immunology
  • Fasciitis, Necrotizing / surgery*
  • Follow-Up Studies
  • Humans
  • Immunocompromised Host
  • Instillation, Drug
  • Male
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Middle Aged
  • Neck
  • Negative-Pressure Wound Therapy / methods*
  • Severity of Illness Index
  • Skin Transplantation / methods
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / surgery*
  • Treatment Outcome
  • Wound Healing / physiology

Substances

  • Anti-Bacterial Agents