title: Use of negative pressure wound therapy with instillation in the management of cervical necrotizing fasciitis.
abstract: BACKGROUND
  Cervical necrotizing fasciitis is an aggressive infection that can be rapidly fatal if aggressive therapies are not initiated early. Negative pressure wound therapy has been established as an effective tool in promoting wound healing, but its use in the acutely infected wound has been avoided because it limits frequent irrigations and standard dressing changes.
  
  
  METHODS
  We discuss a novel application of negative pressure wound therapy with instillation in an immunocompromised patient with extensive cervical necrotizing fasciitis.
  
  
  RESULTS
  The negative pressure wound therapy with instillation provided pain relief by minimizing the frequency of dressing changes, increased the speed of healing, helped to control infection, and facilitated the development of a healthy wound bed sufficient for reconstruction with a split thickness skin graft.
  
  
  CONCLUSIONS
  The role of negative pressure wound therapy with instillation continues to expand and can be used in the management of both acute and chronic wounds in the head and neck.
authors.affiliation: University Hospitals Case Medical Center, Otolaryngology - Head and Neck Surgery, Cleveland, Ohio.
authors.forename: Jonathan K
authors.initials: JK
authors.lastname: Frankel
authors.affiliation: University Hospitals Case Medical Center, Otolaryngology - Head and Neck Surgery, Cleveland, Ohio.
authors.forename: Rod P
authors.initials: RP
authors.lastname: Rezaee
authors.affiliation: University Hospitals Case Medical Center, Plastic Surgery, Cleveland, Ohio.
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Harvey
authors.affiliation: University Hospitals Case Medical Center, Otolaryngology - Head and Neck Surgery, Cleveland, Ohio.
authors.forename: Evan R
authors.initials: ER
authors.lastname: McBeath
authors.affiliation: University Hospitals Case Medical Center, Otolaryngology - Head and Neck Surgery, Cleveland, Ohio.
authors.forename: Chad A
authors.initials: CA
authors.lastname: Zender
authors.affiliation: University Hospitals Case Medical Center, Otolaryngology - Head and Neck Surgery, Cleveland, Ohio.
authors.forename: Pierre
authors.initials: P
authors.lastname: Lavertu
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D003646:Debridement / Q000379:methods; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000276:immunology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D016867:Immunocompromised Host; D007322:Instillation, Drug; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D009333:Neck; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D012720:Severity of Illness Index; D016038:Skin Transplantation / Q000379:methods; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: cervical; instillation; necrotizing fasciitis; negative pressure therapy; wound vacuum therapy