Treatment of a large defect of the chest wall in a child using a negative pressure wound dressing

Bonnet, F; Pavy, Bernard; Beaudoın, Sylvie; Dubousset, Jean; Mitrofanoff, M.

doi:10.1080/02844310600699499

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…However, the extensive chest wound of our patient was infected and it was difficult to find a vessel to perform vascular anastomosis. In addition, although negative pressure wound therapy and vacuum‐assisted closure techniques represent two alternatives to reconstruct anterior chest wall defect, no reports are available using these methods to treat a full‐thickness chest wall defect with exposure of pericardium and ribs because the negative pressure may be harmful for the respiratory and cardiovascular systems of the patient. Skoracki et al indicated in their study that the use of negative pressure wound therapy was contraindicated over exposed organs, and the manufacturer of vacuum‐assisted closure devices also warned against their use in patients whose wounds contained necrotic tissues .…”

Section: Discussionmentioning

confidence: 99%

“…The injury following major electrical burn occurs occasionally in the workplace, and the reconstruction of anterior chest wall defect as a result of this injury represents a very challenging surgery, as some life‐threatening complications may arise owing to delayed or failed reconstruction in such scenario. Many techniques are currently available for the repair of anterior chest wall defect, such as split skin graft , flap transplantation , negative pressure wound therapy , and vacuum‐assisted closure . However, these previous methods are considered not suitable to repair anterior chest wall defect following major electrical burn as in this case immediate coverage of the wound is of vital importance.…”

Section: Introductionmentioning

confidence: 99%

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Pedicled full‐thickness abdominal flap combined with skin grafting for the reconstruction of anterior chest wall defect following major electrical burn

Zhao

Xian

et al. 2013

International Wound Journal

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Successful reconstruction of extensive anterior chest wall defect following major electrical burn represents a very challenging surgery. Herein we report the first case using pedicled full-thickness abdominal flap combined with skin grafting to treat this injury with severe infection and exposure of pericardium and ribs in a Chinese patient. Following the performance of chest debridement to remove necrotic and infected tissues and the injection of broad-spectrum antibiotics to reduce infection, a pedicled full-thickness abdominal flap was used to cover the exposed pericardium and ribs, and skin grafting from the right leg of the patient was done to cover the exposed vital tissues. The patient was followed up for a total of 3·5 years, and satisfactory cosmetic and functional outcomes were obtained without complications. This report provides an effective method for the surgeons who encounter similar cases where reconstruction of extensive anterior chest wall is required.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pedicled full‐thickness abdominal flap combined with skin grafting for the reconstruction of anterior chest wall defect following major electrical burn

Zhao

Xian

et al. 2013

International Wound Journal

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“…An der Körperoberfläche wird die Unterdrucktherapie auch zum temporären Bauchdeckenverschluss und bei größeren Substanzdefekten z. B. der Bauch- oder Thoraxwand genutzt [ 3 , 4 ].…”

Section: Hintergrundunclassified

“…ITNPT was given over a duration of m = 10 days (2-18 days), change interval m = 4 d (2-6 d). The application of intrathoracic negative pressure dressings was performed m = 3.5 (1)(2)(3)(4)(5)(6) times. The empyema cavity continuously reduced in size and was cleansed by the suction.…”

Section: Introductionmentioning

confidence: 99%

Intrathorakale Unterdrucktherapie des Pleuraempyems unter Einsatz einer offenporigen Drainagefolie

et al. 2023

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Zusammenfassung Einleitung Anhand einer Fallserie berichten wir über unsere ersten Erfahrungen mit einer intrathorakalen Unterdrucktherapie (ITNPT) in der stadienadaptierten Therapie des Pleuraempyems (PE). Material und Methoden Die ITNPT ist eine Weiterentwicklung der Unterdrucktherapie für die intrathorakale Anwendung. Nach thoraxchirurgischem offenen Débridement wurde ein intrathorakaler Unterdruckverband installiert. Als Drainageelemente verwendeten wir eine dünne offenporige doppellagige Drainagefolie (OF) mit offenporigen Polyurethanschäumen (PUS). Ausschließlich die OF wurde in direktem Kontakt zum Lungenparenchym angelegt. Die Unterdruckerzeugung erfolgte mit einer elektronischen Pumpe (kontinuierlicher Sog, −75 mm Hg). In der Revisionthorakotomie wurde je nach Lokalbefund die ITNPT beendet oder fortgeführt. Ergebnisse Es wurden 31 Patienten im PE-Stadium II und III behandelt. Die ITNPT erfolgte bereits beim Primäreingriff (n = 17) oder bei Revision (n = 14). Die ITNPT erfolgte über einen Dauer von m = 10 Tagen (2–18 Tage), Wechselintervall m = 4 d (2–6 d). Die intrathorakaler Unterdruckverband-Anlage wurde in m = 3,5 (1–6) mal vorgenommen. Die Empyemhöhle verkleinerte und reinigte sich unter dem Sog kontinuierlich. Die OF hat ein minimales Eigenvolumen bei maximaler Resorptionsoberfläche. Nach Anlage des Unterdrucks besteht kein intrathorakales Totvolumen, das Parenchym kann sich entfalten. Diskussion Die schonenden Materialeigenschaften der OF ermöglichen die ITNPT zur Behandlung des Pleuraempyems. Es ist eine gezielte lokale intrathorakale Sanierung des septischen Focus in Ergänzung zur operativen Therapie möglich. Das Behandlungsregime erfordert wiederholte operative Verbandswechsel. Die Methode ist geeignet zur Behandlung komplizierter PIeuraempyeme im Stadium II und III. Konklusion Die OF kann als intrathorakales Drainageelement zur ITNPT bei Pleuraempyemen verwendet werden. Das Indikationsspektrum der Unterdrucktherapie erweitert sich um diese neue Anwendungsoption.

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“…Negative pressure is created by connecting a hose to an electronic pump. On the body surface, negative pressure therapy is also used for temporary abdominal wall closure and for larger tissue defects, e.g., of the abdominal or thoracic wall [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Intrathoracic negative pressure therapy for pleural empyema using an open-pore drainage film

et al. 2023

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Background We report our initial experience with intrathoracic negative pressure therapy (ITNPT) in the stage-adjusted treatment of pleural empyema (PE) based on a case series. Materials and methods ITNPT represents a further development for intrathoracic use. After thoracic surgical open debridement, an intrathoracic negative pressure dressing was inserted. The drainage elements were a thin open-pore double-layer drainage film (OF) with open-pore polyurethane foams (PUF). Only the OF was placed in direct contact with the lung parenchyma. Negative pressure was generated using an electronic pump (continuous suction, −75 mm Hg). In revision thoracotomies, ITNPT was stopped or continued depending on local findings. Results In total, 31 patients with stage II and III pleural empyema underwent ITNPT, which was administered during the primary procedure (n = 17) or at revision (n = 14). Treatment duration was a mean of 10 days (2–18 days) with a mean change interval of 4 days (2–6 days). Intrathoracic negative pressure dressings were applied a mean of 3.5 (1–6) times. The empyema cavity continuously reduced in size and was cleansed by the suction. The OF has a minimum intrinsic volume with maximum absorption surface. Once negative pressure is established, there is no intrathoracic dead volume and the parenchyma can expand. The protective material properties of OF make ITNPT suitable for the treatment of pleural empyema. Targeted local intrathoracic drainage of the septic focus is a possible adjunct to surgery. The surgical dressings must be changed repeatedly. The method is suitable for the treatment of complex stage II and III pleural empyemas. Conclusion The OF can be used as an intrathoracic drainage element for ITNPT in pleural empyema. This new application option expands the range of indications for negative pressure therapy.

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Treatment of a large defect of the chest wall in a child using a negative pressure wound dressing

Cited by 6 publications

References 10 publications

Pedicled full‐thickness abdominal flap combined with skin grafting for the reconstruction of anterior chest wall defect following major electrical burn

Pedicled full‐thickness abdominal flap combined with skin grafting for the reconstruction of anterior chest wall defect following major electrical burn

Intrathorakale Unterdrucktherapie des Pleuraempyems unter Einsatz einer offenporigen Drainagefolie

Intrathoracic negative pressure therapy for pleural empyema using an open-pore drainage film

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