PMC4916313_01
The extraoral physical examination revealed extensive necrotic tissue in the cervical area.
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The extraoral physical examination revealed extensive necrotic tissue in the cervical area, fetid odor, hyperemia, and edema (Figure 1).
Installation of a Pen Rose irrigation drain.
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The patient was submitted to surgical removal of necrotic tissue, debridement of the surrounding tissues, installation of a Pen Rose irrigation drain (physiologic solution 0.9%), and intravenous administration of Meropenem 500 mg for 10 days (Figure 2).
(a) After seven days and (b) after 21 days, dehiscence of the wound edges was observed.
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After seven days, dehiscence of the wound edges was observed, a new surgical debridement was carried out, and occlusive dressing with silver alginate was applied and exchanged every 48 hours for 21 days (Figures 3(a) and 3(b)).
(a) After 30 days and (b) after seven weeks using silver alginate, a favorable healing was observed.
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After 30 days, the patient was discharged (Figure 4(a)), though complete repair of the surgical wound was not observed, as that only happened seven weeks after the operation by secondary intention (Figure 4(b)).