From Gravity to Affinity: Transitioning From Penrose Drains to Dialkylcarbamoyl Chloride (DACC)-Coated Technology in the Adjunctive Management of a Deep Neck Infection

Deep neck space infections (DNSIs) are life-threatening emergencies requiring rapid surgical source control and systemic antibiotic therapy. While surgical decompression traditionally relies on passive Penrose drains, these drains do not actively manage local microbial bioburden. We report the case of a 72-year-old male presenting with an extensive odontogenic cervical phlegmon extending to the chest wall. Emergency incision and drainage was performed, and a Penrose drain was placed. Microbiological cultures of the purulent exudate grew Staphylococcus aureus. On post-operative day (POD) 1, given the high purulent output (15 cc), the drainage strategy was transitioned to a dialkylcarbamoyl chloride (DACC)-coated dressing to actively sequester local pathogens through hydrophobic interaction. Following application, purulent output dropped to 7 cc on POD 2 (a 53% reduction), and the wound completely resolved by POD 7. While the patient's primary recovery was undoubtedly driven by surgical decompression and systemic antibiotics, this single-case observation suggests that transitioning to a DACC-coated dressing represents a feasible and possible adjunctive option for managing high-volume exudate in the sub-acute phase of fascial infections.