Multifunctional Irrigation-Assisted Vacuum Drainage versus Traditional Drainage in the Treatment of Odontogenic Deep Fascial Infection: A Retrospective Cohort Study

Abstract

Odontogenic deep fascial space infection in the head and neck is a common potentially fatal clinical problem. Traditional drainage method is considered laborious and gravity-dependent. In this study, we aimed to evaluate the clinical effect of a modified multifunctional irrigation-assisted vacuum drainage (MIVD) by comparing it with the traditional drainage method in the treatment of odontogenic deep fascial infection. Patients and Methods: Patients diagnosed with odontogenic deep fascial space infection in the Second Affiliated Hospital, Zhejiang University School of Medicine, China between March 2018 and March 2021 were studied. We divided the patients into two groups based on the drainage method they received: patients with the MIVD device were included in the MIVD group, patients with traditional drainage were included in the traditional group. Data were collected retrospectively including baseline characteristics and treatment outcome variables. Results: A total of 65 patients were included. All the patients were eventually cured. There were no significant differences in age, gender, diabetes, end stage renal disease, autoimmune diseases, other systemic diseases, tobacco use, number of the infected spaces, preoperative white blood cell count and C-reactive protein between the two groups. The number and frequency of manual irrigation by clinicians (MIC), time required for white blood cell count to return to normal levels (TWBC), time required for C-reactive protein to return to normal levels (TCRP), the length of hospitalization and the length and total cost of antibiotics use were significantly less in the MIVD group. There was no significant difference in the cost of hospitalization between the 2 groups. Conclusion:The MIVD device significantly reduced the number and frequency of MIC, TWBC, TCRP, the length of hospitalization and the length and total cost of antibiotics use in comparison with the traditional drainage method. It provided a favorable treatment method for patients with odontogenic deep fascial space infection in the head and neck.

Mediastinitis

“…(61,62,63) Tanto en la mediastinitis necrotizante descendente como en la perforación esofágica, la prioridad, es el tratamiento de la lesión causante con drenaje cervical y mediastínico concurrente y generoso. (64,65,66,67,68,69) El manejo endoscópico de las perforaciones esofágicas o fugas anastomóticas con stents ha sido descrito en la literatura y es una opción aceptable si se dispone de experiencia. En ciertas situaciones, la terapia de heridas con presión negativa colocada endoscópicamente ha mostrado resultados prometedores.…”

Multifunctional Irrigation-Assisted Vacuum Drainage versus Traditional Drainage in the Treatment of Odontogenic Deep Fascial Infection: A Retrospective Cohort Study [Letter]

“…Recently, He et al 1 released a paper in the Infection and Drug Resistance, entitled “Multifunctional Irrigation-Assisted Vacuum Drainage versus Traditional Drainage in the Treatment of Odontogenic Deep Fascial Infection: A Retrospective Cohort Study.” The results mentioned in the original paper 1 are inaccurate, since the authors did not take into account the warm alkaline solutions of hydrogen peroxide, which allowed the authors to belittle the effectiveness of pharmacotherapy of purulent wounds. In essence, the article by He et al 1 is devoted to proving the advantages of the modified multifunctional vacuum drainage with irrigation support (MIVD) developed by them in the treatment of patients with odontogenic infection of the deep fascial space in the head and neck area. They noted that the current traditional drainage method is passive and depends on gravity.…”

“…Recently, He et al 1 released a paper in the Infection and Drug Resistance, entitled "Multifunctional Irrigation-Assisted Vacuum Drainage versus Traditional Drainage in the Treatment of Odontogenic Deep Fascial Infection: A Retrospective Cohort Study. "…”

“…

Dear editorRecently, He et al 1 released a paper in the Infection and Drug Resistance, entitled "Multifunctional Irrigation-Assisted Vacuum Drainage versus Traditional Drainage in the Treatment of Odontogenic Deep Fascial Infection: A Retrospective Cohort Study. "The results mentioned in the original paper 1 are inaccurate, since the authors did not take into account the warm alkaline solutions of hydrogen peroxide, which allowed the authors to belittle the effectiveness of pharmacotherapy of purulent wounds.

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Antimicrobial resistance in patients with odontogenic infections: A systematic scoping review of prospective and experimental studies

“…It has been recognized that the treatment of odontogenic orofacial and neck infections is mainly oriented to the clinical alleviation of suppuration. Nonetheless, antimicrobials adjunct to that therapy is relevant, particularly when there is systemic compromise ( 2 ). The empirical choice of appropriate antimicrobials for the management of these infections is supported by their clinical efficacy, low prices, few adverse events, and good availability ( 3 ).…”