Closed suction drainage for deep neck infections. 2014

Sung Youl Hyun, and Hee Kyun Oh, and Jae Young Ryu, and Jin Joo Kim, and Jin Yong Cho, and Hyeon Min Kim
Department of Thoracic Cardiovascular Surgery, Gachon University Gil Medical Center, South Korea. Electronic address: sungyoul@gilhospital.com.

OBJECTIVE There have been various incision and drainage methods for deep neck infection (DNI). Closed-suction drainage (CSD) has been used to decrease hematoma or to drain pus in other forms of medical surgery. The purpose of this investigation was to evaluate the usefulness of CSD for DNI. METHODS This study consisted of 30 patients who underwent CSD after incision and drainage for DNI between January 2006 and December 2011. The patients' demographics, systemic diseases, methods of airway control, involved spaces, incision, CSD results, duration of hospitalization, and complications were investigated. RESULTS CSD was used to treat 30 DNI patients. Eleven patients (37%) had underlying systemic diseases like diabetes mellitus, hypertension, hepatitis, asthma, etc. Twenty four patients (80%) had odontogenic infections in the mandibular molar region. Tracheostomy was performed in 5 patients (17%). The involved spaces were various from parapharyngeal space to mediastinum (mean: 4.8 spaces), and CSD was applied with drainage lines (mean: 3; 2-7 drains) over the course of 4-37 days (mean 14.6 days). The total amount of drained pus was 8-1344 cc (mean: 406 cc) and the daily amount was 1-61 cc (mean: 28 cc) from each patient. The mean length of hospital stay was 26 days, with a range of 9-83 days. Wound rupture happened in 7% of 56 total incision sites and spontaneous removal of the drain tube occurred in 3% of 91 total tubes. Four patients died because of cardiac arrest, pulmonary edema, and hypoxia. A statistical significance was accepted about total and daily amount of drainage at Pearson's correlation test (p < 0.001). CONCLUSIONS Accurate diagnosis, safe airway management, and early surgical drainage were important in DNI treatment. Compared to other drainage systems, CSD is clinically useful for treating DNI due to minimal incision, convenience of post-operative management, and less postoperative complications.

UI MeSH Term Description Entries
D007902 Length of Stay The period of confinement of a patient to a hospital or other health facility. Hospital Stay,Hospital Stays,Stay Length,Stay Lengths,Stay, Hospital,Stays, Hospital
D008297 Male Males
D008336 Mandibular Diseases Diseases involving the MANDIBLE. Disease, Mandibular,Diseases, Mandibular,Mandibular Disease
D008477 Mediastinal Diseases Disorders of the mediastinum, general or unspecified. Disease, Mediastinal,Diseases, Mediastinal,Mediastinal Disease
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009333 Neck The part of a human or animal body connecting the HEAD to the rest of the body. Necks
D010608 Pharyngeal Diseases Pathological processes involving the PHARYNX. Diseases of Pharynx,Pharynx Diseases,Disease, Pharyngeal,Disease, Pharynx,Diseases, Pharyngeal,Diseases, Pharynx,Pharyngeal Disease,Pharynx Disease
D011654 Pulmonary Edema Excessive accumulation of extravascular fluid in the lung, an indication of a serious underlying disease or disorder. Pulmonary edema prevents efficient PULMONARY GAS EXCHANGE in the PULMONARY ALVEOLI, and can be life-threatening. Wet Lung,Edema, Pulmonary,Edemas, Pulmonary,Pulmonary Edemas,Lung, Wet,Lungs, Wet,Wet Lungs
D002423 Cause of Death Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. Causes of Death,Death Cause,Death Causes
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic

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