Odontogenic space infections typically require surgical incision and drainage for effective source control. While passive drainage remains the standard, manual closed vacuum systems are proposed to enhance exudate evacuation and wound management. This technical note describes the implementation and feasibility of a manual vacuum drainage system in a general hospital setting. The system utilizes a 4.8 mm perforated silicone tube connected to a manual accordion-shaped reservoir. Following surgical debridement, a hermetic seal is created using a 4-0 nylon purse-string suture and reinforced with transparent adhesive film. Negative pressure is generated by manual compression of the reservoir. The technique was safe and straightforward to implement. However, operational challenges included frequent loss of the vacuum seal due to patient mobility and drain obstruction by viscous exudate in the absence of continuous irrigation. These factors led to increased nursing maintenance and lower staff acceptability compared to conventional methods. Manual closed vacuum drainage is a technically viable and safe alternative for odontogenic infections but is limited by operational constraints in non-intensive care settings. Future refinements, such as integrated irrigation channels, are necessary to optimize clinical performance.
Magesty et al. (Thu,) studied this question.