Liebman Robert Michael, Hanubal Krishna S, Dziegielewski Peter T
Otolaryngology-Head and Neck Surgery, Memorial Health University Medical Center, Savannah, Georgia.
Department of Otolaryngology-Head and Neck Surgery, University of Florida College of Medicine, Gainesville, Florida.
Semin Plast Surg. 2022 Dec 13;37(1):9-18. doi: 10.1055/s-0042-1759562. eCollection 2023 Feb.
Negative pressure wound therapy (NPWT) has had an expanded role in the management of complex wounds including its increasing use for complex wounds in the head and neck region. Challenges for use in the head and neck region include variations in surface topography and the proximity of sensitive mouth, nose, ear, eye, and tracheal openings. Despite these challenges, NPWT has been used in the head and neck immediately following free flap surgery, to prepare wounds for skin grafting or local flaps, to treat orocutaneous and pharyngocutaneous fistulas, to treat necrotizing and deep neck space infections, to temporize and palliate, and to treat chronic wounds with exposed bone and hardware among others. This review demonstrates the proven track record of successful uses of NPWT in the aforementioned scenarios, provides suggestions to improve efficacy, as well as an algorithm for use in certain clinical situations.
负压伤口治疗(NPWT)在复杂伤口的处理中发挥着越来越重要的作用,包括其在头颈部复杂伤口治疗中的应用日益增多。在头颈部使用NPWT面临的挑战包括表面地形的差异以及敏感的口腔、鼻腔、耳部、眼部和气管开口的临近。尽管存在这些挑战,NPWT已在游离皮瓣手术后立即用于头颈部,为皮肤移植或局部皮瓣准备伤口,治疗口腔皮肤和咽皮肤瘘,治疗坏死性和深部颈部间隙感染,进行临时处理和缓解症状,以及治疗伴有外露骨骼和固定器械的慢性伤口等。本综述展示了NPWT在上述情况下成功应用的可靠记录,提供了提高疗效的建议,以及在某些临床情况下的使用算法。