| Open window thoracostomy treatment of empyema is accelerated by vacuum-assisted closure. | |
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MedLine Citation:
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PMID: 19766795 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Recurrent thoracic empyema in the presence of residual lung tissue can be treated with an open window thoracostomy (OWT). Vacuum-assisted closure (VAC) of these large thoracic defects is a novel option. METHODS: Nineteen patients with residual lung tissue received an OWT for treatment of recurrent thoracic empyema. In this retrospective case series, 8 patients (aged 58 +/- 20 years, all male) were treated conventionally, and 11 patients (aged 53 +/- 17 years, 8 male) were treated with VAC. RESULTS: The application of the VAC system resulted in rapid debridement of the thoracic cavity and reexpansion of the residual lung tissue. The duration of OWT and VAC therapy was 39 +/- 17 and 31 +/- 19 days, respectively. All 11 patients were amenable for subsequent closure using pedicled muscular flaps. In 2 patients, VAC therapy alone resulted in complete closure of the OWT. The average duration of follow-up was 46 +/- 19 months. All patients, except 1, have recovered well. One patient died of nonpulmonary causes. In the non-VAC group (n = 8), the OWT was managed conventionally by application of saline-soaked gauzes. In 2 patients, the OWT was eventually closed using pedicled muscular flaps (after 75 and 440 days, respectively). Four patients died of OWT-related complications (1 bleeding, 3 recurrent infections) during follow-up; 1 patient died of a cause unrelated to OWT. The average duration of OWT was 933 +/- 1,422 days. CONCLUSIONS: When compared with conventional management of OWT, VAC therapy accelerates wound healing and improves reexpansion of residual lung tissue in patients with OWT after empyema, allowing rapid surgical closure. |
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Authors:
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Meindert Palmen; H Nathalie A M van Breugel; Gijs G Geskes; Arne van Belle; Jos M H Swennen; André H M Drijkoningen; Rene R van der Hulst; Jos G Maessen |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 88 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-09-21 Completed Date: 2009-10-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 1131-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiothoracic Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Empyema, Pleural / diagnosis, therapy* Female Follow-Up Studies Humans Male Middle Aged Negative-Pressure Wound Therapy / methods* Retrospective Studies Thoracostomy / methods* Tomography, X-Ray Computed Treatment Outcome Young Adult |
| Comments/Corrections | |
Comment In:
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Ann Thorac Surg. 2009 Oct;88(4):1136-7
[PMID:
19766796
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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