PMC7718123_01
Extended swelling and necrotic soft tissue area.
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Physical examination revealed that swelling extended through cervical region, with evident necrotic soft tissue areas and pus presence (Fig. 1).
Tomografic images: a) axial image, b and c) sagittal image demonstrate spread of infection within submandibular area.
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There was no evidence of mediastinal inflammatory involvement (Fig. 2).
a) Second debridement, before application of NWPT. b) domestic vacuum devised.
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During operative time, a handcrafted vacuum device was made with gauze, a sounder connected to the central extraction system and an adhesive film selling the injure (Fig. 3).
24 hs of negative pressure wound therapy.
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After 24-h treatment we decided to place calcium alginate within the wound for further healing stimulation (Fig. 4).
First control after being released from hospital.
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When the results of bacteriological examination and antibiogram became available, the patient was released from hospital and continued with ambulatory treatment (Fig. 5).
Follow-up outpatient after 18 months.
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The patient was very pleased with the final result (Fig. 6).