Liu Weijiao, Gu Wei, Jin Xiaofeng, Wang Jian
Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Department of Otolaryngology-Head and Neck Surgery, Beijing Friendship Hospital Pinggu Campus, Capital Medical University, Beijing, People's Republic of China.
Infect Drug Resist. 2021 Oct 5;14:4091-4096. doi: 10.2147/IDR.S334203. eCollection 2021.
Surgical drainage is an essential part of treatment for deep neck infections (DNIs) or deep neck multiple-space infections (DNMIs). With the emergence and application of new technologies and new materials, vacuum-assisted closure (VAC) in the treatment of DNMIs has been reported. However, reports on the timing of VAC placement are limited. Herein, we compared simultaneous versus staged VAC placement in the treatment of DNMIs.
Medical data from 24 patients with DNMIs who had received VAC treatment in the last five years were analyzed. The patients were classified into a simultaneous VAC placement group (11 patients) and a staged VAC placement group (13 patients) according to the timing of VAC placement when incision and drainage were performed.
No differences in baseline characteristics were found between the two groups. All patients in the two groups survived and recovered. The hospitalization duration (days), time to wound healing (days), number of debridement procedures, and disease course (days) in the simultaneous VAC placement group and staged VAC placement group were 10 (4-18) and 22 (8-35), 21 (4-39) and 50 (9-86), one (1-2) and two (1-4), and 31.5 (11-49) and 56 (19-98), respectively. The results in the simultaneous VAC placement group were better than those in the staged VAC placement group (P = 0.001, 0.016, 0.045, and 0.016, respectively). The numbers of VAC sponge changes in the simultaneous VAC placement group and staged VAC placement group were two (1-2) and two (1-4), respectively, with no statistically significant difference (P = 0.336).
Simultaneous VAC placement during incision and drainage may shorten the wound healing time, hospitalization duration, and disease course and may reduce the number of debridement procedures.
手术引流是治疗深部颈部感染（DNIs）或深部颈部多间隙感染（DNMIs）的重要组成部分。随着新技术和新材料的出现与应用，已有关于真空辅助闭合（VAC）治疗DNMIs的报道。然而，关于VAC置入时机的报道有限。在此，我们比较了同期与分期VAC置入在DNMIs治疗中的效果。
分析了过去五年内接受VAC治疗的24例DNMIs患者的医疗数据。根据切开引流时VAC置入的时机，将患者分为同期VAC置入组（11例）和分期VAC置入组（13例）。
两组患者的基线特征无差异。两组所有患者均存活并康复。同期VAC置入组和分期VAC置入组的住院时间（天）、伤口愈合时间（天）、清创次数和病程（天）分别为10（4 - 18）和22（8 - 35）、21（4 - 39）和50（9 - 86）、1（1 - 2）和2（1 - 4）、31.5（11 - 49）和56（19 - 98）。同期VAC置入组的结果优于分期VAC置入组（P分别为0.001、0.016、0.045和0.016）。同期VAC置入组和分期VAC置入组的VAC海绵更换次数分别为2（1 - 2）和2（1 - 4），差异无统计学意义（P = 0.336）。
切开引流时同期置入VAC可缩短伤口愈合时间、住院时间和病程，并可减少清创次数。
