Effectiveness of negative pressure wound therapy in Ludwig's angina: a retrospective study of 18 cases.

Objective: To investigate the effectiveness of negative pressure wound therapy (NPWT) for Ludwig's angina (LA).

Methods: We retrospectively reviewed 18 patients with LA admitted to the 82nd Group Army Hospital of PLA between October 2014 and October 2021. All patients underwent surgical drainage and debridement within 6 h after admission. A minimally invasive approach involving bilateral small incisions in the submandibular area was used to perform the procedure. An NPWT device was applied for positive drainage of the involved spaces after debridement. Postoperatively, the patients received the appropriate supportive care and antibiotic therapy. Data collection encompassed sex, age, systemic diseases, dressing change frequency, NPWT duration, wound healing time, and ICU stay length. Follow-up was performed to evaluate recurrence, scarring, and neck mobility. For comparative analysis, control data were obtained from LA patients treated with conventional surgical drainage between January 2008 and September 2014. Descriptive statistics and Student's t-test were employed for statistical analysis.

Results: In the NPWT group, all patients had uneventful courses during hospitalization and were discharged upon complete wound healing. Fifteen patients required only a single session of surgical debridement with NPWT, while the remaining three underwent two procedures. Upon NPWT device removal, all infectious cavities exhibited clean wounds with mature granulation tissue formation. Compared to the conventional surgery group, the NPWT group demonstrated a significantly shorter wound healing time (15.33 ± 3.93 vs. 19.50 ± 2.17 days; p = 0.025), reduced ICU stay duration (0.61 ± 0.61 vs. 2.17 ± 0.75 days; p < 0.001) and markedly fewer dressing changes (2.17 ± 0.38 vs. 17.00 ± 3.16; p < 0.001).

Conclusions: NPWT demonstrated excellent effectiveness in the management of LA. Compared to conventional surgical debridement and drainage, it offers several distinct clinical advantages, including accelerated wound healing, shortened ICU stays, and reduced dressing change frequency. These benefits are clinically linked to both reduced postoperative pain perception and decreased nursing workload. Additionally, smaller incisions result in less surgical trauma and improved cosmetic outcomes. NPWT should be considered as a viable approach in the management of LA. Future randomized controlled trials are needed to confirm NPWT's superiority in larger cohorts.

Clinical trial number: Not applicable.