Abstract
Negative pressure wound therapy has greatly advanced the field of wound healing for nearly two decades, by providing a robust surgical adjunct technique for accelerating wound closure in acute and chronic wounds. However, the application of negative pressure wound therapy in maxillofacial applications has been relatively under utilized as a result of the physical articulations and contours of the head and neck that make it challenging to obtain an airtight seal for different negative pressure wound therapy systems. Adapting negative pressure wound therapies for maxillofacial applications could yield significant enhancement of wound closure in maxillofacial applications. The current review summarizes the basic science underlying negative pressure wound therapy, as well as specific maxillofacial procedures that could benefit from negative pressure wound therapy.
Highlights
Negative pressure wound therapy (NPWT) is the application of a continuous or intermittent subatmospheric pressure to a localized wound environment using a topical negative pressure dressing (TNPD) connected to a vacuum pump [1,2]
Microdeformation is advantageous for the proliferation phase of wound healing as the TNPD microdeformation acts on the extracellular matrix initiating mechanosignaling within the fibroblasts, epithelial cells, and myofibroblasts to stimulate cell proliferation, differentiation, angiogenesis, and neurogenesis [58]
This paper retrospectively reviewed the use of NPWT in several complicated maxillofacial situations, such as exposed calvarial bone, bolster dressing for large facial skin grafts, and wound management following necrotizing fasciitis debridement
Summary
Negative pressure wound therapy (NPWT) is the application of a continuous or intermittent subatmospheric pressure to a localized wound environment using a topical negative pressure dressing (TNPD) connected to a vacuum pump [1,2]. TNPD are typically open-cell reticulated foams, polyurethane or other material, or gauze-based vacuum dressing. NPWT is known as subatmospheric pressure (SAP), topical negative pressure (TNP), vacuum-assisted closure (V.A.C.), and microdeformational wound therapy (MDWT), and has greatly impacted the field of wound and surgical care over the past nearly 20 years [3]. The current manuscript will briefly review the history of wound healing, the basic science behind NPWT, the considerations for maxillofacial applications, and future improvements for NPWT
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