USE OF NEGATIVE PRESSURE WOUND THERAPY (NPWT) IN ODONTOGENIC CERVICAL NECROTIZING FASCIITIS (OCNF): A CASE REPORT

Diana Sofia Pedraza-Alonso; Cristian Camilo Torres-Alvarez; Andrés Felipe Fernandez-Macias; Juan Sebastián Pérez-Acosta; Juan Pablo Rodríguez Mora

doi:10.5327/2525-5711.513

Autores/as

Diana Sofia Pedraza-Alonso School of Dentistry, Universidad Nacional de Colombia, Bogotá D.C. – Colombia https://orcid.org/0009-0008-0440-9897
Cristian Camilo Torres-Alvarez School of Dentistry, Universidad Nacional de Colombia, Bogotá D.C. – Colombia https://orcid.org/0009-0000-5571-4121
Andrés Felipe Fernandez-Macias School of Dentistry, Universidad Nacional de Colombia, Bogotá D.C. – Colombia https://orcid.org/0009-0006-1106-9523
Juan Sebastián Pérez-Acosta School of Dentistry, Universidad Nacional de Colombia, Bogotá D.C. – Colombia https://orcid.org/0009-0004-2869-6481
Juan Pablo Rodríguez Mora School of Dentistry, Universidad Nacional de Colombia, Bogotá D.C. – Colombia https://orcid.org/0009-0009-3198-1861

DOI:

https://doi.org/10.5327/2525-5711.513

Palabras clave:

cervical necrotizing fasciitis, negative pressure wound therapy, odontogenic infection, case report

Resumen

Odontogenic cervical necrotizing fasciitis (OCNF) is a rare and potentially life-threatening condition that requires prompt diagnosis and management. We present the case of a 55-year-old woman under conditions of social neglect, with a history of morbid obesity and hypothyroidism, who presented with a 15-day history of cervical pain and swelling. Physical examination revealed extensive anterior cervical necrosis and a fetid odor, associated with a mandibular odontogenic source. Initial contrast-enhanced computed tomography showed subcutaneous emphysema, fluid collections with air foci, and extension into deep cervical spaces, as well as thrombosis of the internal jugular vein. Broad-spectrum intravenous antibiotic therapy and intensive care unit management were initiated, followed by aggressive surgical debridement, negative pressure wound therapy (NPWT), and surgical reconstruction, with a favorable outcome.

Citas

[1] Zhou L, Li H, Luo G. Consensus on the diagnosis and treatment of adult necrotizing fasciitis (2025 edition). Burns & Trauma 2025;13. https://doi.org/10.1093/burnst/tkaf031.

[2] Böttger S, Zechel-Gran S, Schmermund D, Streckbein P, Wilbrand J-F, Knitschke M, et al. Odontogenic Cervicofacial Necrotizing Fasciitis: Microbiological Characterization and Management of Four Clinical Cases. Pathogens 2022;11:78. https://doi.org/10.3390/pathogens11010078.

[3] Gunaratne DA, Tseros EA, Hasan Z, Kudpaje AS, Suruliraj A, Smith MC, et al. Cervical necrotizing fasciitis: Systematic review and analysis of 1235 reported cases from the literature. Head & Neck 2018;40:2094–102. https://doi.org/10.1002/hed.25184.

[4] Zeng Y, Tu J, Qin J. The mechanism by which negative pressure wound therapy promotes wound healing. Journal of Tissue Viability 2026;35:100982. https://doi.org/10.1016/j.jtv.2025.100982.

[5] Andrews BT, Smith RB, Goldstein DP, Funk GF. Management of complicated head and neck wounds with vacuum‐assisted closure system. Head & Neck 2006;28:974–81. https://doi.org/10.1002/hed.20496.

[6] Inan CH, Yener HM, Yilmaz M, Gözen ED, Erdur ZB, Oroğlu B, et al. Cervical Necrotizing Fasciitis of Odontogenic Origin and Hyperbaric Oxygen Therapy. Journal of Craniofacial Surgery 2017;28:e691–2. https://doi.org/10.1097/scs.0000000000003842.

[7] Kasim Aljanabi KS, almaqbali T, Mustafa A. Head and neck necrotizing fasciitis: the importance of negative pressure wound therapy with literature review. Bull Natl Res Cent 2022;46. https://doi.org/10.1186/s42269-022-00842-9.

[8] Ba-shammakh SA, Alrayes BM, Abu-obead HM, Ba-Shammakh MA, Al-Mohd FM, Ramzoun EH, et al. Vacuum-Assisted Closure Therapy: A Lifesaver in a Case of Neck Necrotizing Fasciitis. Cureus 2023. https://doi.org/10.7759/cureus.44291.

[9] Katoumas K, Mitsopoulos G. Vacuum-assisted closure of a tissue deficit of the submental area in a patient with a necrotizing soft tissue odontogenic infection. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology 2024;137:e119–24. https://doi.org/10.1016/j.oooo.2023.10.013.

[10] Wang Q, Yang X, Wei Z, Lin T, Wang L. The Effect of NPWT on Odontogenic Cervical Necrotizing Fasciitis. Journal of Craniofacial Surgery 2024;36:e227–31. https://doi.org/10.1097/scs.0000000000010564.