Vacuum-assisted closure device for the management of infected postpneumonectomy chest cavities.

Details

Serval ID
serval:BIB_CF60E46AF861
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Vacuum-assisted closure device for the management of infected postpneumonectomy chest cavities.
Journal
Journal of Thoracic and Cardiovascular Surgery
Author(s)
Perentes J.Y., Abdelnour-Berchtold E., Blatter J., Lovis A., Ris H.B., Krueger T., Gonzalez M.
ISSN
1097-685X (Electronic)
ISSN-L
0022-5223
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
149
Number
3
Pages
745-750
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
BACKGROUND: Infected postpneumonectomy chest cavities may be related to chronic postpneumonectomy empyema or arise in rare situations of necrotizing pneumonia with complete lung destruction where pneumonectomy and pleural debridement are required. We evaluated the safety and efficacy of an intrathoracic vacuum-assisted closure device (VAC) for the treatment of infected postpneumonectomy chest cavities.
METHOD: A retrospective single institution review of all patients with infected postpneumonectomy chest cavities treated by VAC between 2005 and 2013. Patients underwent surgical debridement of the thoracic cavity, muscle flap closure of the bronchial stump when a fistula was present, and repeated intrathoracic VAC dressings until granulation tissue covered the entire chest cavity. After this, the cavity was obliterated by a Clagett procedure and closed.
RESULTS: Twenty-one patients (14 men and 7 women) underwent VAC treatment of their infected postpneumonectomy chest cavity. Twelve patients presented with a chronic postpneumonectomy empyema (10 of them with a bronchopleural fistula) and 9 patients with an empyema occurring in the context of necrotizing pneumonia treated by pneumonectomy. In-hospital mortality was 23%. The median duration of VAC therapy was 23 days (range, 4-61 days) and the median number of VAC changes per patient was 6 (range, 2-14 days). Infection control and successful chest cavity closure was achieved in all surviving patients. One adverse VAC treatment-related event was identified (5%).
CONCLUSIONS: The intrathoracic VAC application is a safe and efficient treatment of infected postpneumonectomy chest cavities and allows the preservation of chest wall integrity.
Pubmed
Web of science
Open Access
Yes
Create date
28/04/2015 18:19
Last modification date
20/08/2019 16:49
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