To observe the effect of continuous negative pressure drainage vacuum sealing drainage (VSD) in the treatment of aggravated postoperative infection in maxillofacial and cervical area.

VSD was used to treat severe maxillofacial infection in 8 cases after oral and maxillofacial surgery which had not been improved and continued to be aggravated. After removal of the necrotic substance and comprehensive debridement in the postoperative infection, the wound was covered with vacuum sealing drainage materials washed by 0.9% Sodium Chloride Solution, and drainaged by the continuous negative pressure. The VSD device was removed until the drainage fluid was clear and the wound tissue was free from swelling and tenderness.

After a clear infection of the 6 cases and traditional exchange was used about 7-8 days, the infection was not improved but progressively aggravated. Then the VSD device was placed in the infection area. After 5-15 days′ continuous drainage, the drainage fluid was clear while the swelling of the maxillofacial region disappeared basically, and proliferation of the granulation tissue was seen around the wound and all the wounds healed basically. In one case, the patient was diagnosed as radioactive osteomyelitis of the jaws and repaired with fibular myocutaneous flap. After definite infection and 20 days′ continuous change of medicine, the infection showed progressive aggravation. After placing VSD for 5 days in the operation area, the focal bone was cleared in operating room. After the operation, we continued to change the fresh dressing on the wound, and the wound was healed. One case of postoperative patients with esophageal fistula used the VSD for a long time. After removal of VSD, the drainage fluid was clear, and the swelling of the maxillofacial region was lightened and granulation tissue hyperplasia was seen around the wound. But we could still see a 1 cm × 1 cm fistula on the left neck. MRI enhancement in the left neck showed an irregular occupying lesion of the 3.9 cm × 2.3 cm × 5.0 cm size in the left neck, and an approximately 2.3 cm × 1.4 cm lump lesion in the right neck, considering the swelling of the lymph nodes (postoperative recurrence) .

The VSD is beneficial to control infection, prevent postoperative infection spread and promote healing of wound tissue. It is possible to move and proliferate cancer cells at the same time while using VSD. In the process of application, the indications should be fully considered, and the changes of the invasive region should be closely monitored. When the suspicious lesion or wound were found to be delayed healing, the VSD device should be removed and further treatment should be done according to the specific conditions.