Vacuum‐assisted closure for managing neck abscesses involving the mediastinum

Abstract

A 57-year-old immunocompetent male patient with a deep neck abscess involving the mediastinum was referred to us following unsuccessful treatment at his local hospital with medical therapy and ultrasound-guided aspiration. After initial evaluation and resuscitation, a contrast-enhanced computed tomography (CT) scan was performed, and the patient was transferred for surgical drainage. A vacuum-assisted closure (VAC) device was used as a surgical drain to help prevent reaccumulation of the purulent collections. A repeat CT scan on day 3 confirmed the absence of residual pus in the mediastinum and in the neck spaces, and the VAC device was removed. Perfect healing of the deep tissues with successful mediastinal toilette was observed. The patient resumed oral meals on postoperative day 10, and 2 days later he was discharged. A 1-month follow-up CT again demonstrated the complete healing and absence of the neck abscess. This case illustrates the possibility of avoiding more extensive and life-threatening procedures, such as open thoracotomy, in the treatment of neck abscesses extending into the mediastinum, and highlights the utility of VAC in the management of deep neck abscesses.

Application of vacuum sealing drainage in oral and maxillofacial surgery

“…In contrast, the removal of exudates from abscesses by NPWT has been well described in the literature [10]. Moreover, in clinical practice, the tissue granulation promoted by VAC allows improved closure of the subcutaneous layers as compared to when using a conventional method [11]. In our 8 cases with severe abscesses, we show that VSD can markedly accelerate the decrease in the pus cavity by promoting thorough drainage.…”

How to avoid life-threatening complications following head and neck space infections: an algorithm-based approach to apply during times of emergency. When and why to hospitalise a neck infection patient

“…This has superior efficacy in terms of secretion drainage, promoting the hypervascularity of the surgical bed, thus avoiding the need for surgical revision of the most extended abscesses. 26 Tracheostomy performed under local anaesthesia is widely considered the standard practice in airway management for patients with deep neck infections. 27 We performed tracheostomy under general anaesthesia in three patients with laterocervical abscesses after nasotracheal intubation.…”

Eficacia de la terapia con presión negativa como parte del manejo de abscesos profundos de cuello

“…Este paciente fue sometido a la aplicación de esta terapia y 3 días después fue retirada, observando una herida limpia, sin absceso. Fue dado de alta a los 10 días y el estudio tomográfico de control realizado al mes demostró curación total (8).…”