A case of an uncontrollable fistula after incisional drainage of submandibular necrotizing fasciitis treated by Negative Pressure Wound Therapy with a V.A.C.<sup>®</sup> ATS system

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  • SAKAKIBARA Akiko
    Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine
  • SAKAKIBARA Shunsuke
    Department of Plastic Surgery, Kobe University Graduate School of Medicine
  • MINAMIKAWA Tsutomu
    Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine
  • SHIGETA Takashi
    Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine
  • HASHIKAWA Kazunobu
    Department of Plastic Surgery, Kobe University Graduate School of Medicine
  • KOMORI Takahide
    Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine

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Other Title
  • 顎下部壊死性筋膜炎に伴う切開排膿後の難治性瘻孔にV.A.C.<sup>®</sup> ATS治療システムによる局所陰圧閉鎖療法を用いた1例
  • 顎下部壊死性筋膜炎に伴う切開排膿後の難治性瘻孔にV.A.C. ATS治療システムによる局所陰圧閉鎖療法を用いた1例
  • アゴ カブ エシセイキンマクエン ニ トモナウ セッカイハイノウ ゴ ノ ナンチセイロウコウ ニ V.A.C. ATS チリョウ システム ニ ヨル キョクショ インアツ ヘイサ リョウホウ オ モチイタ 1レイ

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Abstract

Necrotizing fasciitis is treated by incisional drainage or immediate debridement. Generally, an infected wound should not be sutured or closured, but should be allowed to secondarily heal as an open wound. Treatment of necrotizing fasciitis involving the neck or submandibular region requires careful attention to major blood vessels or nerves. We therefore could not perform debridement radically. The wound should be continuously irrigated or applied ointment, but the presence of a fistula sometimes leads to prolonged wound healing.<BR>We describe our experience with an uncontrollable fistula attributed to debridement of submandibular necrotizing fasciitis, although irrigation had been continued for 6 weeks. After performing Negative Pressure Wound Therapy, with a V.A.C.® ATS system good granulation tissue proliferated in 3 days, and the fistula disappeared. The wound completely healed in 1 week. Furthermore, the clinical course has been good, with no recurrence of a fistula after 3 months. We report a case of early healing of an uncontrollable fistula treated by a V.A.C.® ATS system.

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