Utilisation du système vacuum-assisted closure après une gangrène périnéale étendue à la paroi abdominale

A New Treatment Concept for Bronchial Stump Insufficiency

“…Bronchial stump insufficiency (BSI) is a serious complication of anatomical lung resections in general and of pneumonectomy in particular. Despite a declining incidence (0-12 %) as a result of measures to avoid an excessively long bronchial stump or radical stump dissection, BSI remains a challenging complication with a high mortality secondary to pneumonia of the remaining lung that develops as a result of fluid aspirated from the pleural space or empyema of the pneumonectomy cavity [1][2][3][4][5][6][7][8][9]. BSI manifests clinically either as early insufficiency within the first days or weeks following anatomical lung resection with sudden fever, expectoration and aspiration of infected pleural content or as late insufficiency several months after bronchial closure with a less dramatic course characterized by intermittent or constant fever of 38.0-38.5°C and general weakness [1].…”

“…Vacuum therapy (VT) is an occlusive method for the treatment of acute, chronic and infected wounds. Indications for this method range from the treatment of open fractures, extensive soft tissue defects, infected wounds including sternal osteitis and open abdomen, to perineal gangrene, decubital ulcers and skin transplantation [2][3][4][5][6][7][8][9][10][11][12]. A good overview of the different indications for VT is given by Morykwas et al [13] and Webb and Schmidt [14].…”