{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:52:08Z","timestamp":1791366728201,"version":"4.3.1"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare a combined irrigation\u2010assisted dual\u2010drain suction protocol with single\u2010drain suction alone after surgical drainage of Ludwig's angina.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective comparative cohort study with predefined quasi\u2010randomised alternating allocation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A tertiary referral otolaryngology department in Tuscany, Italy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Sixty adults with odontogenic Ludwig's angina and bilateral submandibular abscesses \u2265\u20094\u2009cm on contrast\u2010enhanced CT were selected from 118 patients screened between January 2015 and April 2025. Consecutive eligible patients were alternately allocated to the combined protocol (Group A,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930) or single\u2010drain suction (Group B,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Length of hospital stay and a prespecified major\u2010complication composite of surgical reintervention, imaging\u2010confirmed mediastinitis, or new postoperative tracheostomy. Superficial wound infection was analysed separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean hospital stay was shorter in Group A than Group B (6.1\u2009\u00b1\u20093.6 vs. 8.2\u2009\u00b1\u20093.4\u2009days; mean difference, \u22122.1\u2009days; 95% CI: \u22123.91 to \u22120.29;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024). The major\u2010complication composite occurred in 2 of 30 patients (6.7%) and 7 of 30 (23.3%), respectively (RR: 0.29; 95% CI: 0.06\u20131.26; Fisher's exact\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.145). Superficial wound infection occurred in 2 of 30 and 5 of 30 patients, respectively. Several inflammatory markers declined more rapidly in Group A.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The combined protocol was associated with shorter hospitalisation and a numerical, non\u2010significant reduction in prespecified major complications. Because it combined irrigation with a dual\u2010drain configuration, the independent contribution of irrigation cannot be determined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.70175","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:09:41Z","timestamp":1791364181000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined Postoperative Irrigation and Dual\u2010Drain Suction Versus Single\u2010Drain Suction in Ludwig's Angina: A Comparative Cohort Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2157-839X","authenticated-orcid":false,"given":"Sante","family":"De Santis","sequence":"first","affiliation":[{"name":"ENT Department SS. Annunziata Hospital  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5226-2278","authenticated-orcid":false,"given":"Jacopo","family":"Cambi","sequence":"additional","affiliation":[{"name":"ENT Department Misericordia Hospital  Grosseto Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7389-2033","authenticated-orcid":false,"given":"Elena","family":"Cantone","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Health and Nutrition Sciences, Otolaryngology Unit University of Calabria (UNICAL), SS. Annunziata Hospital  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9829-2229","authenticated-orcid":false,"given":"Giuseppe","family":"Chiarella","sequence":"additional","affiliation":[{"name":"Unit of Audiology, Phoniatrics and Vestibology, Regional Centre for Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine University Magna Graecia  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7851-4414","authenticated-orcid":false,"given":"Emmanuel Pio","family":"Pastore","sequence":"additional","affiliation":[{"name":"University of Calabria  Cosenza Italy"},{"name":"Department of Health Sciences University of Genoa  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5955-2753","authenticated-orcid":false,"given":"Stefania","family":"Galassi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology SS. 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