Osteoradionecrosis and microvascular free flap failure managed with negative pressure wound therapy: A case report

Gigliotti, Michael J.; Patel, Neel; McLaughlin, Caroline; Rothermel, Alexis; Henry, Cathy R.; Rizk, Elias

doi:10.1080/02688697.2021.1940845

Cited by 5 publications

(6 citation statements)

References 21 publications

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“…In an attempt to overcome this, a color‐coding system similar to that used traditionally only with the Cochrane risk of bias tool was employed, and each domain was marked as either low (green), unclear (yellow), or high (red) risk of bias (see Figure 6). 1,6‐9,11,12,21‐43 Assessments showed most studies to have at least one domain at a high or unclear risk of bias.…”

Section: Resultsmentioning

confidence: 99%

“…6 However, NPWT has contraindications, such as residual tumor in the operative bed 7 and ischemic or necrotic tissue. 4 NPWT can be used in various regions of the face, including the upper, middle, and lower thirds, 8,9 as well as neck reconstruction. 2,10,11 Challenges include maintaining an occlusive seal, especially in the middle third, due to facial contours, hair-bearing skin, and facial movements.…”

Section: Introductionmentioning

confidence: 99%

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The efficacy of negative‐pressure wound therapy for head and neck wounds: A systematic review and update

Onderková,

Butler,

Kalavrezos

2023

Head & Neck

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Despite the established benefits of negative‐pressure wound therapy (NPWT) in various wound healing contexts, its application in head and neck surgical cases remains under‐explored. This study aimed to systematically review its effectiveness, safety, and comparative efficacy. Thirty‐one studies from a systematic literature search were identified and analyzed for wound healing response, overall success rate, improvements compared to conventional wound care, and variation in pressure settings, treatment lengths, and dressing change frequency. NPWT showed enhanced outcomes across diverse head and neck wounds, particularly complex post‐reconstructive wounds and severe infections. Despite the predominantly case report/series evidence and lack of standardized NPWT protocols, its benefits over conventional care were clear. NPWT emerges as a promising approach for head and neck wound management, potentially improving patient outcomes and reducing complications. More randomized controlled trials are needed to solidify the evidence and standardize NPWT application protocols.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The efficacy of negative‐pressure wound therapy for head and neck wounds: A systematic review and update

Onderková,

Butler,

Kalavrezos

2023

Head & Neck

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“…This is consistent with the results of our study, steroids are fat‐soluble hormones, including oestrogen and other substances, hormone drugs can prolong the healing time of meningioma surgery wounds, and is likely to induce wound infection. Gigliotti et al 17 analysed the surgical wound treatment of a 56‐year‐old female patient with a history of meningioma following subtotal excision (Simpson Level IV) and extensive radiation therapy. The patient had scalp defects of 15 × 10 cm.…”

Section: Discussionmentioning

confidence: 99%

“…The stitches can be removed after 7–9 days, and if necessary, the stitches should be disassembled first. Incision infection occurs more than 3 days after surgery, and attention should be paid to aseptic operation, careful haemostasis, elimination of dead space, and prevention of cerebrospinal fluid leakage 17,18 . After infection has been found, stitches should be removed and drainage should be timely, and effective antibiotics should be used for treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Incision infection occurs more than 3 days after surgery, and attention should be paid to aseptic operation, careful haemostasis, elimination of dead space, and prevention of cerebrospinal fluid leakage. 17 , 18 After infection has been found, stitches should be removed and drainage should be timely, and effective antibiotics should be used for treatment. In recent years, with the continuous improvement of nursing methods, the protection of surgical incisions has become more and more important.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of risk factors affecting wound healing and wound infection after meningioma resection

Wang,

Shou,

Gao

et al. 2024

International Wound Journal

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To analyse the risk factors affecting wound healing and infection after spinal meningioma resection surgery. The surgical incision healing of 137 patients who underwent spinal meningioma resection at our hospital from January 2021 to January 2024 was analysed. The data collected included physical examination findings, haematological and biochemical measurements, and various scales assessed upon admission and after surgery. These data were then analysed. The surgical wound healing, infection and postoperative complications were statistically analysed. Multiple logistic regression analysis method was used to conduct risk factor analysis on corresponding indicators; the odds ratio and p value of 95% confidence interval were calculated. Factors such as age and smoking history were significantly negatively correlated with wound healing after meningioma resection (odds ratio < 1.000, p < 0.05), while preoperative albumin and platelet count were significantly positively correlated with wound healing (odds ratio > 1.000, p < 0.05). Age, WHO Meningioma Grading, preoperative albumin and preoperative platelet were significantly negatively correlated with wound infection after meningioma resection (odds ratio < 1.000, p < 0.05). The history of virus infection and history of neurological disorders were significantly positively correlated with wound infection (odds ratio > 1.000, p < 0.05). The influence of each factor is different. Age, smoking history, WHO Meningioma Grading, preoperative albumin, preoperative platelets, history of virus infection and history of neurological disorders had the greatest influence on wound healing and infection after meningioma resection.

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Incidence and Factors Associated With the Development of Calvarial Osteoradionecrosis in Patients Treated for Cutaneous Malignancies

Weerakkody,

Nguyen,

Lok

et al. 2024

Craniomaxillofacial Trauma & Reconstruction

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Study Design Retrospective cohort study. Objective Calvarial osteoradionecrosis (ORN) is a rare but devastating complication of radiotherapy. The aim of this study was to describe the cumulative incidence of Calvarial ORN in patients in patients treated for cutaneous malignancy of the scalp. Methods Data was compiled from patient records of a large tertiary hospital Plastic Surgery department and radiotherapy records of an affiliated cancer Center. We included all patients that were treated for cutaneous malignancies of the scalp that received radiotherapy. Patient demographics, cancer stage, treatment modalities, intraoperative details, and patient outcome data were recorded. Patients with incomplete radiotherapy data were excluded. Results We analyzed 105 radiotherapy treatments to the scalp administered to 84 patients and recorded 7 cases of calvarial ORN resulting in a gross incidence of 6.67% per radiotherapy treatment. The parietal bone was the most frequently targeted site of radiotherapy and accordingly the most common site of ORN (85.7%). Median time from radiotherapy dose to the development of ORN was 846 days. Higher number of radiotherapy fractionation ( P = .038), cumulative radiotherapy dose ( P = .035), prolonged radiotherapy duration ( P = .022) and skin grafting ( P = .003) were associated with the development of ORN. Conclusions Our findings suggest radiotherapy variables, such as prolonged radiotherapy duration, increased cumulative dose and higher radiotherapy fractions were strongly associated with the development of ORN. In addition, skin grafting following surgical resection was associated with the development of ORN. Further studies with larger sample sizes are required to further explore this relationship.

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Osteoradionecrosis and microvascular free flap failure managed with negative pressure wound therapy: A case report

Cited by 5 publications

References 21 publications

The efficacy of negative‐pressure wound therapy for head and neck wounds: A systematic review and update

The efficacy of negative‐pressure wound therapy for head and neck wounds: A systematic review and update

Analysis of risk factors affecting wound healing and wound infection after meningioma resection

Incidence and Factors Associated With the Development of Calvarial Osteoradionecrosis in Patients Treated for Cutaneous Malignancies

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