The use of negative pressure dressings in head and neck reconstruction

Abstract

Problem: Significant attention has focused on improving wound healing following head and neck cancer procedures and wound complications are commonly associated with significant morbidity and prolonged hospitalizations. This study demonstrates the utility of negative pressure dressings (NPDs) in head and neck ablative and reconstructive procedures. Methods: In this report, we present 44 cases where NPDs were used as an alternative to, or in combination with, conventional management techniques. Applications included the following: (1) immobilization of split thickness skin grafts (STSGs) in free tissue donor sites (n = 32); (2) immobilization of STSGs in the head and neck region (n = 3); (3) promotion of granulation tissue formation in exposed cervical structures (n = 5); (4) management donor site complications (n = 2); and (5) conservative management of hardware exposures (n = 2). NPDs to immobilize STSG in free tissue transfer donor sites were left in place for 4 to 6 days and measured for percent viability at 1 week and 4 weeks. Results: STSG healing rates were 100% in all patients at 1 week and greater than 95% in 33 of 35 patients at 4 weeks. Healing of STSGs using NPDs was comparable to the application of conventional immobilization techniques that require longer periods of immobilization. NPDs offered a distinct advantage in postoperative monitoring of the extremity for vascular integrity. The application of NPDs to open cervical wounds resulted in the promotion of granulation tissue with 3 days of application, resulting in shorter hospitalizations. Conclusion: NPDs are safe and effective in head and neck reconstruction. We discuss the indications, techniques, and ideal settings for negative pressure wound dressings. The advantages of NPDs over conventional management of head and neck wounds and the associated costs are also discussed. Significance: Negative pressure dressings accelerate wound healing in STSG sites and complicated head and neck wounds. Support: None reported.