Abstract

Simple SummaryThe study has focused on the use of Negative Pressure Wound Therapy (NPWT) specifically in head and neck cancer patients. The sole purpose of using NPWT is to expedite the process of healing as most of the head and neck cancer patients are bound to get post-operative radiotherapy and any delay would further lengthen the treatment and affect the outcome. Previous irradiation and Diabetes Mellitus have detrimental impact on wound healing after NPWT. (1) Background: Negative pressure wound therapy (NPWT) has been effectively used for wound management in comparison to traditional dressings. The purpose of this study was to provide an evidence-based review of NPWT in head and neck cancer patients, as well as the impact of previous irradiation and other risk factors on wound healing. (2) Material and Methods: We conducted a comprehensive search in PubMed, Medline, Embase, Web of Science, and Cochrane Library databases for relevant literature. (3) Results: 15 studies fulfilled the inclusion criteria. The most common etiologies requiring NPWT were defects post tumor resection and flap reconstruction and oro/pharyngo-cutaneous fistulas. The neck was found to be the most common site of involvement (47.3%). The overall wound healing response rate was 87.5%. The median negative pressure recorded was 125 mm of Hg, with a median dressing change time of three days. Previous irradiation (p = 0.01; OR = 4.07) and diabetes mellitus (DM) (p = 0.001; OR = 5.62) were found to be significantly associated with delayed wound healing after NPWT. (4) Conclusion: NPWT treats complex wounds in head and neck cancer patients and should represent a significant armamentarium in head and neck cancers. Previous irradiation and DM have detrimental effects on wound healing after NPWT.

Highlights

  • Negative pressure wound therapy (NPWT) has remained an integral part of wound management for general, orthopedic, and plastic surgeons for more than half a decade [1,2,3,4]

  • The purpose of this comprehensive review was to give a detailed analysis of the use of NPWT in head and neck cancer patients, as well as to analyze the impact of previous irradiation and other risk factors on patients’ wound healing

  • We have reported a case of plate coverage at the mandible–neck junction using the pectoralis major (PM) muscle flap with overlying skin grafting (Figure 3)

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Summary

Introduction

Negative pressure wound therapy (NPWT) has remained an integral part of wound management for general, orthopedic, and plastic surgeons for more than half a decade [1,2,3,4]. Adjustable negative pressure applied via an adhesive film over a foam padding promotes wound healing by removing wound exudate and decreasing interstitial edema and bacterial load at the wound site. This results in increased tissue perfusion and promotes the formation of a well-granulating wound bed [5,6,7]. Delayed wound healing has its own share of financial burdenand treatment-related delays that significantly impact clinical outcomes The purpose of this comprehensive review was to give a detailed analysis of the use of NPWT in head and neck cancer patients, as well as to analyze the impact of previous irradiation and other risk factors on patients’ wound healing

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