gms | German Medical Science

GMS Current Posters in Otorhinolaryngology - Head and Neck Surgery

Deutsche Gesellschaft für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie e.V. (DGHNOKHC)

ISSN 1865-1038

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

Poster

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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

GMS Curr Posters Otorhinolaryngol Head Neck Surg 2011;7:Doc29

DOI: 10.3205/cpo000618, URN: urn:nbn:de:0183-cpo0006180

Published: April 14, 2011

© 2011 Pellant et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Abstract

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.