gms | German Medical Science

82. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

01.06. - 05.06.2011, Freiburg

Interfascial pressure – predictor of wound healing complications in head and neck surgery

Meeting Abstract

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  • corresponding author Arnost Pellant - Faculty of Health Studies, University of Pradubice, Pardubice, Czech Republic
  • Jan Mejzlik - General Hospital Pardubice, Pardubice, Czech Republic

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 82. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Freiburg i. Br., 01.-05.06.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11hnod048

DOI: 10.3205/11hnod048, URN: urn:nbn:de:0183-11hnod0488

Veröffentlicht: 19. April 2011

© 2011 Pellant et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: Wound healing complications: healing by secondary intention, wound dehiscence, pharyngo cutaneous fistula etc. in the course of surgical treatment of patients with advanced head and neck malignancies are not rare. Capillary perfusion plays an important role in tissue healing and is influenced negatively by high interfascial pressure. We sought to ascertain the extent to which pressure within a defined neck compartment could be used as predictor for wound healing.

Methods: Prospectively 30 patients were considered, all having various head and neck malignancies that were treated surgically. In the course of surgery a pressure microsensor was implanted into the defined neck compartment and data was collected over the first 48 hours postoperatively. Logistic regression analysis was used to determine the strength of IP as predictor for wound healing.

Results: The majority, 23 patients (76.6%), had good healing of the surgical wound and seven patients (23.4%) suffered late wound complications: these resulted in healing by secondary intention, requiring prolonged antibiotic administration and nasogastric feeding tube insertion. Mean IP in these two groups were 6.12 mmHg (95% CI 5.9, 6.4) and 11.8 mmHg (95% CI 10.9, 12.8) respectively. The mean IP was found to be higher during the whole period of 48 hours in the group of bad healed patients (P<0.001).

Conclusions: This study demonstrates the feasibility of IP measurement in the neck, verifies it in a human clinical experiment and highlights its potential in the prediction of wound healing complications. The study seems to suggest that for high probability of good wound healing (greater than 90%) the IP values should be monitored and maintained below the risk levels.