A device for applying postsurgical pressure to the lateral face

Objective. The purpose of this study was to improve the effect of pressure applied on the lateral face after operations, particularly after parotid su rgery for prevention of complications, especially the formation of salivary fistula. Study design. A pressure instrument (face pad) was designed to fit all type s of facial morphology. The blood flow velocity of the superficial temporal artery was measured by means of a Doppler detector in 30 healthy volunteer s under 2 different conditions, with and without the face pad. Values for 2 parameters, peak velocity and average peak velocity, were determined for t he purpose of selecting an appropriate pressure. Each of 47 patients who ha d undergone regional parotidectomy received pressure with the face pad for 3 days; the results were compared with those in a control group of 44 patie nts who had undergone similar operations but received traditional packing d ressings. Results. The peak velocities of the superficial temporal artery with and wi thout the face pad were not significantly different (t = 1.541, P = .132) w hen a pressure value of 4 to 5 N was applied. However, the average peak vel ocity of the superficial temporal artery increased significantly (t = 3.678 , P = .001) with the face pad. The 47 patients with the face pad had no pos toperative parotid fistula; in contrast, salivary fistula developed in 5 of the 44 control cases, for an overall fistula rate of 11.36%. A significant difference existed between the 2 groups (P = .023). Conclusions. The face pad worked quantitatively and was stable and comforta ble. A pressure of 4 to 5 N on the lateral face did not influence the blood flow of the superficial temporal artery. The higher peak velocity was corr elated with regional stenosis of the temporal vein caused by pressure. Evid ently, the face pad can reduce postoperative complications after parotidect omy; moreover, it makes pressure dressing easy and shortens the in-hospital days of the patient as well.