Vacuum-assisted closure device: a useful tool in the management of severe intrathoracic infections.

Détails

ID Serval
serval:BIB_6429AE185D65
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Vacuum-assisted closure device: a useful tool in the management of severe intrathoracic infections.
Périodique
Annals of Thoracic Surgery
Auteur(s)
Saadi Alend, Perentes J.Y., Gonzalez M., Tempia A.C., Wang Y., Demartines N., Ris H.B., Krueger T.
ISSN
1552-6259 (Electronic)
ISSN-L
0003-4975
Statut éditorial
Publié
Date de publication
2011
Volume
91
Numéro
5
Pages
1582-1589
Langue
anglais
Notes
Conference Information: 46th Annual Meeting of the Society-of-Thoracic-SurgeonsFt Lauderdale, FL, JAN 25-27, 2010
Résumé
Background. This study is an evaluation of the vacuum-assisted closure (VAC) therapy for the treatment of severe intrathoracic infections complicating lung resection, esophageal surgery, viscera perforation, or necrotizing pleuropulmonary infections.Methods. We reviewed the medical records of all patients treated by intrathoracic VAC therapy between January 2005 and December 2008. All patients underwent surgical debridement-decortication and control of the underlying cause of infection such as treatment of bronchus stump insufficiency, resection of necrotic lung, or closure of esophageal or intestinal leaks. Surgery was followed by intrathoracic VAC therapy until the infection was controlled. The VAC dressings were changed under general anesthesia and the chest wall was temporarily closed after each dressing change. All patients received systemic antibiotic therapy.Results. Twenty-seven patients (15 male, median age 64 years) underwent intrathoracic VAC dressings for the management of postresectional empyema (n = 8) with and without bronchopleural fistula, necrotizing infections (n = 7), and intrathoracic gastrointestinal leaks (n = 12). The median length of VAC therapy was 22 days (range 5 to 66) and the median number of VAC changes per patient was 6 (range 2 to 16). In-hospital mortality was 19% (n = 5) and was not related to VAC therapy or intrathoracic infection. Control of intrathoracic infection and closure of the chest cavity was achieved in all surviving patients.Conclusions. Vacuum-assisted closure therapy is an efficient and safe adjunct to treat severe intrathoracic infections and may be a good alternative to the open window thoracostomy in selected patients. Long time intervals in between VAC changes and short course of therapy result in good patient acceptance. (Ann Thorac Surg 2011;91:1582-90) (C) 2011 by The Society of Thoracic Surgeons
Pubmed
Web of science
Création de la notice
13/05/2011 11:05
Dernière modification de la notice
20/11/2020 7:24
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