Acute otitis externa because of negative pressure wound therapy applied over the head and ear canal for scalping treatment

Abstract

Scalping is considered a complex wound with difficult treatment, requiring early surgical intervention, reconstructive plastic surgery, and a multidisciplinary team. The reconstruction of the scalp frequently requires a combination of therapies, including temporary coverage, such as negative pressure wound therapy (NPWT). Complications of NPWT, such as bleeding, infection, and pain, have been described. However, there is no report of acute otitis externa (AOE) because of NPWT. In this article, we present an unprecedented clinical case – a female patient who developed AOE after scalping treatment with NPWT applied over the head and ear canal. We consider that it may be a result of the direct physical action of subatmospheric pressure, the presence of dressing covering the external meatus, and alteration of the bacterial population.

Single-stage full-depth scalp reconstruction with Matriderm®: a clinical case report and a brief literature review

“…Matriderm® was installed ( Figure 7 ) as a salvage solution since the free flap technique was not an option due to patient’s poor health status. Negative pressure wound therapy (NPWT) in combination with a DRT is a safe and effective option that accelerates and promotes healing [ 8 ]. Due to patient’s poor health status, lack of discipline and supportive environment a NPWT system option seemed impractical.…”

Negative Pressure Wound Therapy in the Head and Neck: A Summary of Uses and Application Techniques

“…This resulted in a case of acute otitis externa in one report. 44 While rare, there are reports of development of toxic shock syndrome with use of NPWT. 45 The only manufacturer recommendation for antibiotics is in the setting of osteomyelitis, otherwise their use is at the discretion of the treating physician.…”

The role of negative pressure wound therapy (NPWT) on the treatment of pyoderma gangrenosum: A systematic review and personal experience

“…After discussing with the patient about the risks of the pathergy phenomenon, we decided to use NPWT for 7 days to accelerate the formation of the granulation tissue, with the protection of the ear canal (Figure 6, above). 18 Then, we performed a fullthickness skin graft with the lower abdomen as a donor area (Figure 6, below, left).…”