[Difficult Wounds in the Head and Neck Area]

Wound care in the head and neck region is particularly challenging due to its complex anatomy, functional significance, and aesthetic requirements. A careful approach that considers systemic and local factors, as well as consistent wound care, are crucial for healing with minimal complications. Traumatic, iatrogenic, and chronic wounds each require specific strategies, with wound closure, suture technique, and appropriate wound dressings significantly influencing success. Difficult wounds, such as those following bite injuries or complex postoperative defects, benefit from an interdisciplinary, individualized approach. This case report of a pharyngocutaneous fistula illustrates that conventional surgical procedures are not always sufficient. In addition, combined endo- and external NPWT can be a helpful option under certain conditions to promote granulation formation and support wound closure, although it is not yet standard practice. Future developments will be characterized by digital documentation, standardized follow-up, bioactive wound dressings, and regenerative procedures. The goal remains to shorten healing times, reduce complications, and optimize function and cosmetic outcomes. Overall, the article underscores the importance of an interdisciplinary and individualized approach that combines proven methods with innovative techniques to meet the complex requirements of complex wound care in the head and neck region.