2.2 Treatment
All patients underwent laboratory tests, electrocardiogram and neck CT.
According to the clinical manifestations, signs, neck CT examination and
general physical conditions of patients, individualized treatment plan
was made. All patients were initially treated with
amoxicillin/clavulanic acid and metronidazole, and then adjusted
according to culture and sensitivity reports. If the abscess has been
formed in a large area, the abscess should be cut and drained as soon as
possible according to the scope of the abscess. Vascular forceps were
used for blunt separation and wide opening of the abscess cavity.
Fingers were used to explore and open the dangerous abscess cavity, so
as to facilitate the full drainage of the pus. The abscess cavity were
repeatedly washed with hydrogen peroxide, diluted complex iodine and
normal saline. The dressing was changed daily to wash the pus cavity,
and the drainage gauze was placed in the traditional treatment group.
The dressing was changed twice a day if too more pus in the cavity and
then reduced according to the situation until the incision healed. In
the pyogenic cavity aerobic therapy + negative pressure drainage group,
the patients were treated with oxygen therapy in the pus cavity (oxygen
flow tube was placed in the pus cavity) after the operation. The oxygen
flow rate was 1-4 L/min, 18-24 h/day. When there was no obvious purulent
secretion, the incision was sutured and negative pressure drainage was
placed. The color of the drainage fluid was observed every day. When the
color of the drainage fluid is clear and less than 10 mL, the negative
pressure drainage was removed. Tracheotomy was performed according to
the patient’s respiratory condition and the scope of abscess. If the
abscess has not yet formed or formed in a small range, it should be paid
close attention to the condition, actively anti-inflammatory, strengthen
nutritional treatment, and adjust the treatment plan according to the
change of the condition.