Chen Shu-Jun, Ji Ning, Chen Yu-Xuan, Xiao Jian-Rui, Wei Xiao-Zong, Liu Yan-Kun
Department of Stomatology, the 82nd Group Army Hospital of PLA, No. 991, Baihuadong Road, Baoding, 071000, P. R. China.
Quality Management Department, the 82nd Group Army Hospital of PLA, No. 991, Baihuadong Road, Baoding, P. R. China, 071000.
BMC Surg. 2025 May 22;25(1):223. doi: 10.1186/s12893-025-02957-y.
To investigate the effectiveness of negative pressure wound therapy (NPWT) for Ludwig's angina (LA).
We retrospectively reviewed 18 patients with LA admitted to the 82nd Group Army Hospital of PLA between October 2014 and October 2021. All patients underwent surgical drainage and debridement within 6 h after admission. A minimally invasive approach involving bilateral small incisions in the submandibular area was used to perform the procedure. An NPWT device was applied for positive drainage of the involved spaces after debridement. Postoperatively, the patients received the appropriate supportive care and antibiotic therapy. Data collection encompassed sex, age, systemic diseases, dressing change frequency, NPWT duration, wound healing time, and ICU stay length. Follow-up was performed to evaluate recurrence, scarring, and neck mobility. For comparative analysis, control data were obtained from LA patients treated with conventional surgical drainage between January 2008 and September 2014. Descriptive statistics and Student's t-test were employed for statistical analysis.
In the NPWT group, all patients had uneventful courses during hospitalization and were discharged upon complete wound healing. Fifteen patients required only a single session of surgical debridement with NPWT, while the remaining three underwent two procedures. Upon NPWT device removal, all infectious cavities exhibited clean wounds with mature granulation tissue formation. Compared to the conventional surgery group, the NPWT group demonstrated a significantly shorter wound healing time (15.33 ± 3.93 vs. 19.50 ± 2.17 days; p = 0.025), reduced ICU stay duration (0.61 ± 0.61 vs. 2.17 ± 0.75 days; p < 0.001) and markedly fewer dressing changes (2.17 ± 0.38 vs. 17.00 ± 3.16; p < 0.001).
NPWT demonstrated excellent effectiveness in the management of LA. Compared to conventional surgical debridement and drainage, it offers several distinct clinical advantages, including accelerated wound healing, shortened ICU stays, and reduced dressing change frequency. These benefits are clinically linked to both reduced postoperative pain perception and decreased nursing workload. Additionally, smaller incisions result in less surgical trauma and improved cosmetic outcomes. NPWT should be considered as a viable approach in the management of LA. Future randomized controlled trials are needed to confirm NPWT's superiority in larger cohorts.
Not applicable.
探讨负压伤口治疗(NPWT)用于路德维希咽峡炎(LA)的有效性。
我们回顾性分析了2014年10月至2021年10月期间收治于中国人民解放军第82集团军医院的18例LA患者。所有患者在入院后6小时内均接受了手术引流和清创。采用一种微创方法,在下颌下区域做双侧小切口进行手术。清创后应用NPWT装置对受累间隙进行积极引流。术后,患者接受适当的支持治疗和抗生素治疗。数据收集包括性别、年龄、全身性疾病、换药频率、NPWT持续时间、伤口愈合时间和重症监护病房(ICU)住院时长。进行随访以评估复发、瘢痕形成和颈部活动度。为进行对比分析,对照数据取自2008年1月至2014年9月期间接受传统手术引流治疗的LA患者。采用描述性统计和学生t检验进行统计分析。
在NPWT组中,所有患者住院期间病程平稳,伤口完全愈合后出院。15例患者仅需进行一次NPWT联合手术清创治疗,其余3例接受了两次手术。拆除NPWT装置后,所有感染腔的伤口均清洁,有成熟的肉芽组织形成。与传统手术组相比,NPWT组的伤口愈合时间显著缩短(15.33±3.93天对19.50±2.17天;p = 0.025),ICU住院时间缩短(0.61±0.61天对2.17±0.75天;p < 0.001),换药次数明显减少(2.17±0.38次对17.00±3.16次;p < 0.001)。
NPWT在LA的治疗中显示出卓越的有效性。与传统手术清创和引流相比,它具有几个明显的临床优势,包括加速伤口愈合、缩短ICU住院时间和减少换药频率。这些益处与术后疼痛感知减轻和护理工作量减少在临床上相关。此外,较小的切口导致手术创伤更小,美容效果更佳。NPWT应被视为LA治疗中的一种可行方法。未来需要进行随机对照试验以在更大队列中证实NPWT的优越性。
不适用。