Vacuum assisted closure in the management of wound healing disorders in the head and neck: A retrospective analysis of 23 cases

Background: Since the middle of the 1990s vacuum-assisted closure (VAC) has been used in many areas of surgery to manage complex wounds and impaired wound healing. Until recently, little attention has been paid to this treatment modality in the field of head and neck surgery. The evaluation of its efficacy in wound healing disorders of the head and neck was the aim of this study. Material and methods: Patients with complex wounds and impaired healing treated with VAC therapy between 2008 and 2011 were included into the study. VAC dressings were changed every 3 days and improvements in wound healing were documented. Results: 23 patients were treated with VAC therapy, in 18 cases (78%) closure of the defect could be reached without any further surgical procedure. 5 patients needed subsequent regional flap reconstruction to close the remaining defect. All of these patients had undergone salvage surgery in a previously irradiated neck before. Conclusion: Vacuum assisted closure is an effective treatment in the management of wound healing disorders and complex wounds in the head and neck. It offers a useful, non-invasive modality to close even large defects in the area. Previous irradiation seems to have a significant negative influence on the outcome of the therapy, but more data are required to assess these effects. (C) 2013 Elsevier Inc. All rights reserved.