Bharath Ansha, Madabhushi Srikanth S C
Government Dental College and Research Institute, Bangalore, India.
University of Colorado, Boulder, CO, USA.
Med Devices (Auckl). 2021 Nov 9;14:327-337. doi: 10.2147/MDER.S320723. eCollection 2021.
Infection of the facial spaces and the associated exudate can often necessitate surgical intervention. Whilst traditional decompression methodologies have reduced the mortality rate from complications such as Ludwig's Angina, there has been relatively little innovation in the procedure to minimize treatment times and patient distress. Negative pressure wound therapy, which can yield improvements to treatment time, wound healing and patient experience, has gained traction in abscess treatments in other parts of the body but seen limited adoption in maxillofacial surgeries.
A focused literature review explores the existing treatment methodologies for infected facial space decompression and identifies obstacles to implementing negative pressure wound therapy in maxillofacial surgeries. A novel drainage tool, which features a sleeved sponge over a perforated drainage tube, is proposed. Virtual prototyping and structural analyses of the novel drainage device including a parametric design study are presented.
The parametric study validates the proposed tool's biocompatibility in terms of overall flexural and axial stiffness between the tool and complex structures in the head and neck. Ultimately, this work presents a necessary first step in the development of specialized drainage tools to promote the adoption of negative pressure wound therapy for infections of facial spaces.
面部间隙感染及相关渗出物常常需要进行外科干预。虽然传统的减压方法已降低了诸如路德维希咽峡炎等并发症的死亡率，但在尽量缩短治疗时间和减轻患者痛苦的手术方法方面创新相对较少。负压伤口治疗可缩短治疗时间、促进伤口愈合并改善患者体验，已在身体其他部位的脓肿治疗中得到应用，但在颌面外科手术中的应用有限。
进行一项重点文献综述，探讨感染性面部间隙减压的现有治疗方法，并确定在颌面外科手术中实施负压伤口治疗的障碍。提出一种新型引流工具，其特点是在多孔引流管上套有海绵。展示了该新型引流装置的虚拟原型制作和结构分析，包括参数设计研究。
参数研究在该工具与头颈部复杂结构之间的整体弯曲和轴向刚度方面验证了所提出工具的生物相容性。最终，这项工作为开发专门的引流工具迈出了必要的第一步，以促进负压伤口治疗在面部间隙感染中的应用。
