Govea-Camacho Luis Humberto, Astudillo-Carrera Andrea, Hermosillo-Sandoval José Manuel, Rodríguez-Reynoso Sergio, González-Ojeda Alejandro, Fuentes-Orozco Clotilde
Departamento de Cirugía de Cabeza y Cuello, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
Departamento de Cirugía General, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
Cir Cir. 2016 Jul-Aug;84(4):275-81. doi: 10.1016/j.circir.2015.12.004. Epub 2016 Feb 21.
The presence of deep neck abscesses is potentially serious; they can lead to death in a short period of time. The vacuum-assisted closure (V.A.C.) therapy has been used in many areas of surgery for complex wound healing. This treatment modality has recently been considered in the field of head and neck surgery.
Evaluate the efficacy of healing therapy using V.A.C. therapy in deep neck abscesses.
Open-label trial. Patients with deep neck abscesses were included using V.A.C. therapy versus conventional therapy. Cultures were taken before and during surgery, and prior to primary wound closure. The percentages of healing, viable tissue, wound healing time, and hospital stay were evaluated.
A total of 18 patients were included. Affected neck spaces: submaxilar 29%, parapharyngeal 22%, submental 21% and masticatory 13%. The final postsurgical culture was negative in 78%. Viable tissue of the wound for the V.A.C. group was 42%, and for the control group was 36% (p=0.025). Healing time was 22±6 days and 38±15.5, respectively (p = 0.01). The mean number of hospital stay was 12 days for both groups.
Therapy with V.A.C. is useful in the treatment of deep neck abscesses; it decreased healing time as a result of more viable tissue allowing suture closure of the wound in a shorter period.
颈部深部脓肿的存在可能很严重，可在短时间内导致死亡。负压封闭引流（V.A.C.）疗法已在外科手术的许多领域用于复杂伤口的愈合。最近，这种治疗方式在头颈外科领域得到了考虑。
评估使用V.A.C.疗法治疗颈部深部脓肿的愈合疗效。
开放标签试验。纳入采用V.A.C.疗法与传统疗法治疗的颈部深部脓肿患者。在手术前、手术期间以及初次伤口闭合前进行培养。评估愈合百分比、存活组织、伤口愈合时间和住院时间。
共纳入18例患者。受累颈部间隙：颌下29%，咽旁22%，颏下21%，咀嚼肌13%。术后最终培养结果78%为阴性。V.A.C.组伤口的存活组织为42%，对照组为36%（p = 0.025）。愈合时间分别为22±6天和38±15.5天（p = 0.01）。两组的平均住院天数均为12天。
V.A.C.疗法在治疗颈部深部脓肿方面是有用的；由于有更多的存活组织，使得伤口能够在更短的时间内进行缝合闭合，从而缩短了愈合时间。
