{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T03:15:41Z","timestamp":1771557341142,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,11,23]],"date-time":"2017-11-23T00:00:00Z","timestamp":1511395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The care and the management of the healing of difficult wounds at the level of the skull\u2010facial face many problems related to patient compliance and the need to perform multiple dressings, with long periods of healing and, occasionally, a very long hospitalisation period. The introduction and evolution of negative pressure wound therapy (NPWT) in the treatment of difficult wounds has resulted in better healing, with a drastic reduction in terms of time and biological costs to the patient and cost to the health care system. The main aim of this study is to describe and discuss, using out our experience, the usefulness of NPWT in the cranial\u2010facial\u2010cervical region. We studied 16 patients with complex wounds of the cranial\u2010facial\u2010cervical region treated with NPWT. We divided clinical cases in four groups: cervicofacial infectious disease, healing complications in oncological\u2010reconstructive surgery, healing complications of injury with exposure of bone and\/or internal fixations and healing complications in traumatic injury with loss of substance. We evaluated complete or incomplete wound healing; application time, related also to hospitalisation time; days of intensive care unit (<jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>) stay; management of the upper airways; timing of medication renewal; and patient comfort and compliance (on a scale of 1\u20135). Depression values were always between \u221275 and \u2212125 <jats:styled-content style=\"fixed-case\">mmHg<\/jats:styled-content> in a continuous aspiration pattern. For every patient, we used the <jats:styled-content style=\"fixed-case\">ActiVAC<\/jats:styled-content> Therapy Unit, derived from the vacuum\u2010assisted closure system (Kinetic Concepts Inc., San Antonio, TX). Medication renewals were performed every 48\u201372 hours. The NPWT application time ranged from 4 to 22 days (mean of 11\u00b757 day). Therapy was effective to gain a complete <jats:italic>restitutio ad integrum<\/jats:italic> in every patient included in the group of cervicofacial infectious disease. Therapy has, however, been well tolerated in our series; this is probably due to the decreased number of applications, the ease of use and the comfort of the system relative to traditional dressing. Results were satisfactory for most of cases treated; faster and more effective wound healing was achieved. The lower number of NPWT applications, relating to standard dressings, led to an increase in patient comfort and compliance and a decrease in the use of medical, and in some cases economic, resources according to international literature.<\/jats:p>","DOI":"10.1111\/iwj.12802","type":"journal-article","created":{"date-parts":[[2017,11,24]],"date-time":"2017-11-24T04:54:38Z","timestamp":1511499278000},"page":"16-23","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Negative pressure wound therapy in complex cranio\u2010maxillofacial and cervical wounds"],"prefix":"10.1111","volume":"15","author":[{"given":"Giorgio","family":"Novelli","sequence":"first","affiliation":[{"name":"Department of Maxillofacial Surgery University of Milano\u2010Bicocca, Asst\u2010 San Gerardo Hospital  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Daleffe","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery University of Milano\u2010Bicocca, Asst\u2010 San Gerardo Hospital  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gisella","family":"Birra","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery University of Milano\u2010Bicocca, Asst\u2010 San Gerardo Hospital  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Canzi","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery Niguarda Hospital  Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Mazzoleni","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery University of Milano\u2010Bicocca, Asst\u2010 San Gerardo Hospital  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Boni","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery University of Milano\u2010Bicocca, Asst\u2010 San Gerardo Hospital  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"Maino","sequence":"additional","affiliation":[{"name":"Outpatient clinic \u2013 Advanced Wound Care, Department of Professional Health Asst\u2010San Gerardo Hospital  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Giussani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Milano\u2010Bicocca, Asst\u2010San Gerardo Hospital  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Sozzi","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery University of Milano\u2010Bicocca, Asst\u2010 San Gerardo Hospital  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Bozzetti","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery University of Milano\u2010Bicocca, Asst\u2010 San Gerardo Hospital  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,11,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/S0002-9610(34)90995-8","article-title":"Drainage","volume":"40","author":"Chaffin R","year":"1934","journal-title":"Am J Surg"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1962.00740040109005"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0007-1226(98)80142-2"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1957.tb03778.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-195508000-00011"},{"key":"e_1_2_7_7_1","first-page":"711","article-title":"A portable technique for the maintenance of constant sterile postoperative wound suction","volume":"46","author":"Breslau RC","year":"1959","journal-title":"Surgery"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.5540740106"},{"key":"e_1_2_7_9_1","first-page":"488","article-title":"Vacuum sealing as treatment of soft tissue damage in open fractures","volume":"96","author":"Fleischmann W","year":"1993","journal-title":"Unfallchirurgr"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199706000-00001"},{"key":"e_1_2_7_11_1","unstructured":"OrgillDP BayerL NeuwalderJ FelterR. 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