Negative-pressure Wound Therapy for Periocular Necrotizing Fasciitis

Gillespie, John W.; Pandya, Jui; Agarwal, Savita; Gassman, Andrew; Krakauer, Mark

doi:10.1097/gox.0000000000001921

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…In an attempt to overcome this, a color‐coding system similar to that used traditionally only with the Cochrane risk of bias tool was employed, and each domain was marked as either low (green), unclear (yellow), or high (red) risk of bias (see Figure 6). 1,6‐9,11,12,21‐43 Assessments showed most studies to have at least one domain at a high or unclear risk of bias.…”

Section: Resultsmentioning

confidence: 99%

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The efficacy of negative‐pressure wound therapy for head and neck wounds: A systematic review and update

Onderková,

Butler,

Kalavrezos

2023

Head & Neck

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Despite the established benefits of negative‐pressure wound therapy (NPWT) in various wound healing contexts, its application in head and neck surgical cases remains under‐explored. This study aimed to systematically review its effectiveness, safety, and comparative efficacy. Thirty‐one studies from a systematic literature search were identified and analyzed for wound healing response, overall success rate, improvements compared to conventional wound care, and variation in pressure settings, treatment lengths, and dressing change frequency. NPWT showed enhanced outcomes across diverse head and neck wounds, particularly complex post‐reconstructive wounds and severe infections. Despite the predominantly case report/series evidence and lack of standardized NPWT protocols, its benefits over conventional care were clear. NPWT emerges as a promising approach for head and neck wound management, potentially improving patient outcomes and reducing complications. More randomized controlled trials are needed to solidify the evidence and standardize NPWT application protocols.

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Section: Resultsmentioning

confidence: 99%

“…This approach has been reported in a case study by Gillespie et al, where specific adjustments, such as tarsorrhaphy and milder pressure settings, were implemented to ensure patient safety. 32 The success of this treatment underscores the potential for NPWT in managing a wider range of head and neck wounds.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of negative‐pressure wound therapy for head and neck wounds: A systematic review and update

Onderková,

Butler,

Kalavrezos

2023

Head & Neck

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“…In addition to a clinical examination with the detection of characteristic signs and symptoms, including the presence of cutaneous emphysema, the diagnosis of periocular necrotizing fasciitis requires imaging examination, such as an MRI, to confirm or support the diagnosis [2,3,36,37]. Surgical treatment is always necessary and must be combined with antibiotic treatment tailored to the sensitivity of the germs involved in the etiology of the disease.…”

Section: Discussionmentioning

confidence: 99%

Periorbital Facial Necrotizing Fasciitis in Adults: A Rare Severe Disease with Complex Diagnosis and Surgical Treatment—A New Case Report and Systematic Review

Pertea,

Fotea,

Luca

et al. 2023

JPM

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(1) Background: Necrotizing fasciitis (NF) is a severe and aggressive pathology with a rapid progression and high mortality risk. Periocular NF is a rare condition associated with a lower mortality risk but significantly higher disabling sequelae. (2) Methods: We present the case of a 67-year-old homeless patient, a victim of assault, with multiple untreated comorbidities (diabetes mellitus, cardiac conditions, and schizophrenia) and a delayed diagnosis of periocular necrotizing fasciitis. The condition showed a cyclical evolution influenced by the existing comorbidities, and the patient underwent both surgical and medical treatment with a multidisciplinary team. Additionally, we report a systematic review of cases from the literature. (3) Results: The patient’s survival outcomes were favorable; however, the sequelae were disabling, not only concerning aesthetic aspects but also due to the loss of the affected eye globe. The systematic review revealed the rarity of such cases and the peculiarities of the presented case compared to those reported in the literature up to this point. (4) Conclusions: Understanding the signs, symptoms, and predisposing factors, as well as the potential rare localizations of NF, including the periocular region, can lead to the early diagnosis and treatment with good functional and aesthetic outcomes, minimizing significant disabilities.

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“…However, since NPWT removes excessive edema fluid and decreases the amount of bacteria [8,9], some surgeons have already successfully healed necrotizing fasciitis with NPWT [11][12][13][14]. Gillespie et al [11] treated a 44-year-old man with bilateral periocular necrotizing fasciitis using NPWT and covered the wound with skin graft. Nouraei et al [13] reported healing the necrotizing fasciitis of the neck using NPWT and skin grafting.…”

Section: Discussionmentioning

confidence: 99%

Effective Treatment Using Negative Pressure Wound Therapy for Necrotizing Fasciitis of Scalp Originating from Odontogenic Infection

Kim

Choi

et al. 2020

J Wound Manag Res

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Necrotizing fasciitis is an uncommon but life-threatening infectious disease. In this report, we describe the cases of two patients who presented with an extremely rare necrotizing fasciitis of the scalp, originating from an odontogenic infection, and who were treated successfully with negative pressure wound therapy (NPWT). Both patients had diabetes mellitus and were admitted to the emergency department. Facial computed tomography revealed multifocal fluid collection, soft tissue swelling, and thickening from the perioral region to the scalp. Extensive incision, drainage, and debridement were performed. Taking into account the pain the patients were suffering and their general condition, NPWT was then applied instead of a povidone iodine-soaked dressing. With appropriate antibiotics, serial surgical debridement, and NPWT, the infection was controlled within a month from the first session of NPWT. For wound closure, one patient underwent primary closure and split thickness skin grafting with bone decortication, and the other patient underwent only primary closure. Although necrotizing fasciitis is associated with high morbidity and mortality, both patients’ general conditions improved, and their surgical wounds healed successfully. NPWT can be a safe, effective treatment for necrotizing fasciitis of the head and neck, and it can reduce both patients’ pain and physicians’ effort.

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Negative-pressure Wound Therapy for Periocular Necrotizing Fasciitis

Cited by 4 publications

References 6 publications

The efficacy of negative‐pressure wound therapy for head and neck wounds: A systematic review and update

The efficacy of negative‐pressure wound therapy for head and neck wounds: A systematic review and update

Periorbital Facial Necrotizing Fasciitis in Adults: A Rare Severe Disease with Complex Diagnosis and Surgical Treatment—A New Case Report and Systematic Review

Effective Treatment Using Negative Pressure Wound Therapy for Necrotizing Fasciitis of Scalp Originating from Odontogenic Infection

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