Negative Pressure Wound Therapy (NPWT) in Head and Face Trauma, Can it Change the Reconstruction Ladder?

Kadry, Hamed M.

doi:10.21608/ejprs.2022.220457

Negative Pressure Wound Therapy (NPWT) in Head and Face Trauma, Can it Change the Reconstruction Ladder?

Author

Hamed M. Kadry

The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Cairo University

10.21608/ejprs.2022.220457

Abstract

Introduction: Trauma to the head and neck region especially the face is becoming more and more common due to the speed of our life style. Exposed bone in this region presents a daily challenge to the reconstruction surgeon as each of the options available for reconstruction (grafts, flaps, free flaps over even secondary intentions) comes at a price. Negative Pressure Wound therapy evolved over the last few decades offering a way to cover almost all kinds of raw areas. The effectiveness of NPWT over exposed bones have been studied and proven. The use of NPWT in the head and neck trauma setting is still understudied today due to the specific topographic nature of the head and neck making its fixation challenging. Patients and Methods: This randomized prospective control study was conducted on the first 40 patients presenting to the author in the period from April 2017 to April 2021. Patients were randomized into 2 groups. Group A patients treated with NPWT and Group B patients treated with conventional dressing. NPWT was applied on a continuous mode between 100-125mm Hg. The size of the defect as well as the time needed for healing were one of the main parameters recorded. Results: Out of the 40 patients recruited for this study only 35 patients ( 18 in group A & 17 in group B) fulfilled the inclusion and exclusion criteria The time needed for the raw area to be ready for definitive management was statistically significant with a p-value of <0.001 in favor of the NPWT group. This shows a superiority of the NPWT in reducing the time for healing as well as decreasing the frequency of dressing thus decreasing the psychological burden on the patient. Conclusion: Negative Pressure Wound Therapy is a useful tool in covering head and faces exposed bones with shorter recovery time and more ease and comfort for the patient. This study suggests it as modality for treatment in certain conditions as an alternative and not as replacement for other well established techniques such as local and free flaps.

Keywords

Main Subjects

New technologies and products

References

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