Multifunctional Irrigation-Assisted Vacuum Drainage versus Traditional Drainage in the Treatment of Odontogenic Deep Fascial Infection: A Retrospective Cohort Study

Abstract

Purpose

Odontogenic deep fascial space infection in the head and neck is a common potentially fatal clinical problem. Traditional drainage method is considered laborious and gravity-dependent. In this study, we aimed to evaluate the clinical effect of a modified multifunctional irrigation-assisted vacuum drainage (MIVD) by comparing it with the traditional drainage method in the treatment of odontogenic deep fascial infection.

Patients and Methods

Patients diagnosed with odontogenic deep fascial space infection in the Second Affiliated Hospital, Zhejiang University School of Medicine, China between March 2018 and March 2021 were studied. We divided the patients into two groups based on the drainage method they received: patients with the MIVD device were included in the MIVD group, patients with traditional drainage were included in the traditional group. Data were collected retrospectively including baseline characteristics and treatment outcome variables.

Results

A total of 65 patients were included. All the patients were eventually cured. There were no significant differences in age, gender, diabetes, end stage renal disease, autoimmune diseases, other systemic diseases, tobacco use, number of the infected spaces, preoperative white blood cell count and C-reactive protein between the two groups. The number and frequency of manual irrigation by clinicians (MIC), time required for white blood cell count to return to normal levels (TWBC), time required for C-reactive protein to return to normal levels (TCRP), the length of hospitalization and the length and total cost of antibiotics use were significantly less in the MIVD group. There was no significant difference in the cost of hospitalization between the 2 groups.

Conclusion

The MIVD device significantly reduced the number and frequency of MIC, TWBC, TCRP, the length of hospitalization and the length and total cost of antibiotics use in comparison with the traditional drainage method. It provided a favorable treatment method for patients with odontogenic deep fascial space infection in the head and neck.

Keywords:

• deep fascial space infection
• odontogenic infection
• irrigation
• vacuum drainage
• head and neck

Acknowledgments

The authors thank Menghua Yu, Tian Zhang, Qin Yan and Xiahan Sheng for their help with acquisition of data, photo collecting and illustration.

Abbreviations

MIVD, multifunctional irrigation-assisted vacuum drainage; ESRD, end stage renal disease; MIC, manual irrigation by clinicians; TWBC, time required for white blood cell count to return to normal levels; TCRP, time required for C-reactive protein to return to normal levels; VTE, venous thromboembolism.

Data Sharing Statement

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

Ethics Approval and Informed Consent

This study was approved by the Human Research Ethics Committee of the Second Affiliated Hospital, Zhejiang University School of Medicine (No.2021-0543). Here we would like to give more explanations on ethics issue. Every inpatient was informed that their medical records might be used and informed consent was gotten. As for the choice of treatment method between the MIVD and the traditional drainage method, informed consent was granted by all patients included in this study. In the stage of this retrospective study, we only included patients’ clinical data. No physical contact or surgical procedure was performed on the patients, thus there was no adverse effect on the patients’ physical health. All patients’ information was kept anonymous to ensure privacy protection. Therefore, informed consent was not required for this study.

We strictly abided by the Declaration of Helsinki, clinical research ethics and national laws and regulations on clinical human researches.

Consent for Publication

The authors confirm that the details of all images can be published.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.