Abstract
We reported a case of cervical necrotizing fasciitis requiring tracheotomy, but effectively managed by negative pressure wound therapy (NPWT). A 63-year-old man suffering from swallowing pain was transferred to our hospital for the treatment of cervical abscess. He was in shock state on admission and after the initial stabilization, surgical debridement was performed. NPWT using Vacuum Assisted Closure® (V.A.C.®) system was instituted from the day 6. The aim was to achieve the negative pressure at the wound, where there was an interspace between a tracheostomy orifice and the tube. So, polyurethane foam (V.A.C. GranuFoam) was placed into this interspace and the neck flange of the tracheostomy tube as a unit created a negative pressure environment, that was effective for preventing the spread of infection. On the 56th day, the wound was closed by reconstructive surgery using a pectoralis major myocutaneous flap. Thus, NPWT would be beneficial for the treatment of cervical necrotizing fasciitis even in patients requiring tracheotomy.
