Effectiveness and safety of immediate application of negative pressure wound therapy in head and neck free flap reconstruction: a systematic review

To our knowledge this is the first systematic review of the immediate application of negative pressure wound therapy (NPWT) to the head and neck in free flap reconstruction. We conducted a systematic search of the PubMed and Cochrane databases in October 2021 using the MeSH terms 'negative pressure wound therapy', 'free flaps', 'microsurgery', and 'vacuum-assisted closure'. Included studies evaluated the use of immediate NPWT in head and neck free flap reconstruction. Outcomes, indications, monitoring, and reported complications were retrieved. Of the 908 articles searched, nine published between 2000 and 2021 were included: four retrospective studies and five case series. NPWT was applied to 56 free flaps, and 54 had successful outcomes. The most common reported indication for flap reconstruction was malignancy. NPWT has the potential to be a valuable tool for complicated wounds, and further studies are needed to quantify functional and aesthetic outcomes.