Case Report on Deep Neck Space Wound Management Using NPWT-i/d

Published January 14, 2026 | Version v1

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Deep neck space infections (DNSIs) present significant clinical challenges due to the complex anatomical

architecture of the cervical region and the potential for life-threatening complications. Management is

further complicated in patients with comorbidities such as diabetes mellitus and heavy smoking, which

impair wound healing. This report describes the management of a large (15 × 15 cm) post-operative cervical

wound in a patient with previously undiagnosed diabetes and a history of heavy smoking. Following surgical

drainage of a Klebsiella pneumoniae abscess, the wound cavity displayed persistent slough and purulent

pooling near the carotid sheath. To avoid the morbidity of repeated surgical debridement in this high-risk

zone, Negative Pressure Wound Therapy with Instillation and Dwell time (NPWT-i/d) was utilized.

Conclusion: The application of NPWT-i/d over a 9-day period successfully reduced bioburden, promoted

rapid granulation, and prevented the need for secondary major surgery. This case supports the safe use of

NPWT-i/d as an adjunct in complex head and neck wounds.

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