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Management and postoperative use of double-cannula irrigation–drainage tube in cervical necrotizing fasciitis: a Chinese single-institution experience of 46 patients

  • Head and Neck
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Abstract

Purpose

This study aimed to analyze a Chinese institution’s experience with managing cervical necrotizing fasciitis (CNF) and observe the effects of a new therapeutic approach for postoperative drainage system.

Methods

A retrospective study was established including a total of 46 CNF patients who underwent surgical debridement between April 2006 and April 2018. Analyses of demographic data, etiology, comorbidity, microbiology, complications, treatment methods, duration of treatment, and treatment outcomes were obtained.

Results

There were 16 kinds of microbes cultured in 29 patients. Diabetic patients were more commonly infected by microbes (P < 0.05). There was a significant reduction in the number of operative time (P < 0.05) and length of hospitalization (P < 0.01) with postoperative therapy of double-cannula irrigation–drainage (DCID) system.

Conclusion

CNF management includes controlling for comorbidities especially glycemic control and reasonable utilization of antibiotics and aggressive postoperative therapy. DCID system can effectively reduce operative frequency and duration of hospitalization.

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References

  1. Fenton CC, Kertesz T, Baker G, Sandor GK (2004) Necrotizing fasciitis of the face: a rare but dangerous complication of dental infection. J Can Dent Assoc 70:611–615

    PubMed  Google Scholar 

  2. Stevens DL, Bryant AE (2017) Necrotizing soft-tissue infections. N Engl J Med 377:2253–2265

    Article  Google Scholar 

  3. Paz Maya S, Dualde Beltrán D, Lemercier P, Leiva-Salinas C (2014) Necrotizing fasciitis: an urgent diagnosis. Skeletal Radiol 43:577–589

    Article  Google Scholar 

  4. Shaikh N, Ummunissa F, Hanssen Y, Al Makki H, Shokr HM (2010) Hospital epidemiology of emergent cervical necrotizing fasciitis. J Emerg Trauma Shock 3:123–125

    Article  Google Scholar 

  5. Sandner A, Moritz S, Unverzagt S, Plontke SK, Metz D (2015) Cervical necrotizing fasciitis—the value of the laboratory risk indicator for necrotizing fasciitis score as an indicative parameter. J Oral Maxillofac Surg 73:2319–2333

    Article  Google Scholar 

  6. Elander J, Nekludov M, Larsson A, Nordlander B, Eksborg S, Hydman J (2016) Cervical necrotizing fasciitis: descriptive, retrospective analysis of 59 cases treated at a single center. Eur Arch Otorhinolaryngol 273:1–7

    Article  Google Scholar 

  7. Lanisnik B, Cizmarevic B (2010) Necrotizing fasciitis of the head and neck: 34 cases of a single institution experience. Eur Arch Otorhinolaryngol 267:415–421

    Article  Google Scholar 

  8. Krenk L, Nielsen HU, Christensen ME (2007) Necrotizing fasciitis in the head and neck region: an analysis of standard treatment effectiveness. Eur Arch Otorhinolaryngol 264:917–922

    Article  Google Scholar 

  9. Thrane JF, Pikelis A, Ovesen T (2017) Hyperbaric oxygen may only be optional in head and neck necrotizing fasciitis: a retrospective analysis of 43 cases and review of the literature. Infect Dis 49:792–798

    Article  Google Scholar 

  10. Jallali N, Withey S, Butler PE (2005) Hyperbaric oxygen as adjuvant therapy in the management of necrotizing fasciitis. Am J Surg 189:462–466

    Article  CAS  Google Scholar 

  11. Shupak A, Shoshani O, Goldenberg I, Barzilai A, Moskuna R, Bursztein S (1995) Necrotizing fasciitis: an indication for hyperbaric oxygenation therapy? Surgery 118:873–878

    Article  CAS  Google Scholar 

  12. Bayetto K, Cheng A, Sambrook P (2017) Necrotising fasciitis as a complication of odontogenic infection: a review of management and case series. Aust Dent J 62:317–322

    Article  CAS  Google Scholar 

  13. Mendame Ehya RE, Zhao Y, Zheng X et al (2017) Comparative effectiveness study between negative pressure wound therapy and conventional wound dressing on perforator flap at the Chinese tertiary referral teaching hospital. J Tissue Viability 12:30106–30107

    Google Scholar 

  14. Frankel JK, Rezaee RP, Harvey DJ, Mcbeath ER, Zender CA, Lavertu P (2015) Use of negative pressure wound therapy with instillation in the management of cervical necrotizing fasciitis. Head Neck 37:157–160

    Article  Google Scholar 

  15. Gu G, Ren J, Yuan Y et al (2011) An innovative technique for intra-abdominal abscess drainage using a sump drain by trocar puncture. J Am Surg 77:166–167

    Article  Google Scholar 

  16. Skitarelic N, Mladina R, Morovic M, Skitarelic N (2003) Cervical necrotizing fasciitis: sources and outcomes. Infection 31:39–44

    Article  CAS  Google Scholar 

  17. Hakkarainen TW, Kopari NM, Pham TN, Evans HL (2014) Necrotizing soft tissue infections: review and current concepts in treatment, systems of care, and outcomes. Curr Probl Surg 51:344–362

    Article  Google Scholar 

  18. Fihman V, Raskine L, Petitpas F et al (2008) Cervical necrotizing fasciitis: 8-years’ experience of microbiology. Eur J Clin Microbiol Infect Dis 27:691–695

    Article  CAS  Google Scholar 

  19. Wong CH, Wang YS (2005) The diagnosis of necrotizing fasciitis. Curr Opin Infect Dis 18:101–106

    Article  Google Scholar 

  20. Mao JC, Carron MA, Fountain KR et al (2009) Craniocervical necrotizing fasciitis with and without thoracic extension: management strategies and outcome ☆. Am J Otolaryngol 30:17–23

    Article  Google Scholar 

  21. Djupesland PG (2000) Necrotizing fascitis of the head and neck–report of three cases and review of the literature. Acta Otolaryngol Suppl 543:186–189

    Article  CAS  Google Scholar 

  22. Camino Junior R, Naclerio-Homem MG, Cabral LM, Luz JG (2014) Cervical necrotizing fasciitis of odontogenic origin in a diabetic patient complicated by substance abuse. Braz Dent J 25:69–72

    Article  Google Scholar 

  23. Panda NK, Simhadri S, Sridhara SR (2004) Cervicofacial necrotizing fasciitis: can we expect a favourable outcome? J Laryngol Otol 118:771–777

    Article  Google Scholar 

  24. Dreyer M (2014) The value of early intervention and a multidisciplinary approach in the management of necrotizing fasciitis of the neck and anterior mediastinum of odontogenic origin. J Oral Maxillofac Surg 73:918–927

    Google Scholar 

  25. Flanagan CE, Daramola OO, Maisel RH, Adkinson C, Odland RM (2009) Surgical debridement and adjunctive hyperbaric oxygen in cervical necrotizing fasciitis. Otolaryngol Head Neck Surg 140:730–734

    Article  Google Scholar 

  26. Sukato DC, Ferzli G, Thakkar P, Gordin E (2017) Concurrent external and intraluminal vacuum-assisted closure in head and neck necrotizing fasciitis. Laryngoscope 127:1361–1364

    Article  Google Scholar 

  27. Sarna T, Sengupta T, Miloro M, Kolokythas A (2012) Cervical necrotizing fasciitis with descending mediastinitis: literature review and case report. J Oral Maxillofac Surg 70:1342–1350

    Article  Google Scholar 

  28. Antony S, Terrazas S (2004) A retrospective study: clinical experience using vacuum-assisted closure in the treatment of wounds. J Natl Med Assoc 96:1073–1077

    PubMed  PubMed Central  Google Scholar 

  29. Chen SJ, Ji N, Chen YX et al (2015) Management and maintenance of the airway in cervical necrotising fasciitis: a retrospective analysis of 15 cases. Ret Analy 53:642–646

    CAS  Google Scholar 

  30. Ngo QD, Vickery K, Deva AK (2012) The effect of topical negative pressure on wound biofilms using an in vitro wound model. Wound Repair Regen 20:83–90

    Article  Google Scholar 

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Acknowledgements

XC was supported by a grant from the Key Specialty Construction Project of Health Bureau of Shanghai (Grant No. ZK2019C06) and the Key Disciplines Group Construction Project of Pudong Health Bureau of Shanghai (PWZxq2017-04). EZ was supported by the Young Fundation of Pudong Gongli Hospital of Shanghai (Grant No. 2018YQNJJ-05).

Funding

This work was supported by a grant from the Key Specialty Construction Project of Health Bureau of Shanghai (Grant No. ZK2019C06), the Key Disciplines Group Construction Project of Pudong Health Bureau of Shanghai (PWZxq2017-04), the Young Fundation of Pudong Gongli Hospital of Shanghai (Grant No. 2018YQNJJ-05).

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Author notes

  1. En-hui Zhou and Su-ru Liu contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Otorhinolaryngology, Pudong New Area Gongli Hospital, Shanghai, China

    En-hui Zhou & Xiao-ping Chen

  2. Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China

    En-hui Zhou, Su-ru Liu, Hua-ming Zhu & Hong-liang Yi

Authors
  1. En-hui Zhou
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  2. Su-ru Liu
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  3. Hua-ming Zhu
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  4. Hong-liang Yi
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  5. Xiao-ping Chen
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Contributions

Data collection and analysis: Z, G, Z; manuscript writing: Z; revised the manuscript: Y, L; study design: L, Y

Corresponding author

Correspondence to Xiao-ping Chen.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval

This is a retrospective study. Approval for the release of data for this project was granted by the Ethical Committee of Shanghai Jiao Tong University Affiliated Sixth People’s Hospital.

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All patients provided written informed consent.

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All data generated or analyzed during this study are included in this published article.

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Zhou, Eh., Liu, Sr., Zhu, Hm. et al. Management and postoperative use of double-cannula irrigation–drainage tube in cervical necrotizing fasciitis: a Chinese single-institution experience of 46 patients. Eur Arch Otorhinolaryngol 278, 2975–2981 (2021). https://doi.org/10.1007/s00405-020-06424-7

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  • DOI: https://doi.org/10.1007/s00405-020-06424-7

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