tailieunhanh - Báo cáo y học: "omplex pleural empyema can be safely treated with vacuum-assisted closure"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Complex pleural empyema can be safely treated with vacuum-assisted closure. | Sziklavari et al. Journal of Cardiothoracic Surgery 2011 6 130 http content 6 1 130 JCTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Complex pleural empyema can be safely treated with vacuum-assisted closure 1 1 2 1 2 1 Zsolt Sziklavari Christian Grosser Reiner Neu Rudolf Schemm Ariane Kortner Tamas Szoke and Hans-Stefan Hofmann1 2 Abstract Objective For patients with postoperative pleural empyema open window thoracostomy OWT is often necessary to prevent sepsis. Vacuum-assisted closure VAC is a well-known therapeutic option in wound treatment. The efficacy and safety of intrathoracal VAC therapy especially in patients with pleural empyema with bronchial stump insufficiency or remain lung has not yet been investigated. Methods Between October 2009 and July 2010 eight consecutive patients mean age of years with multimorbidity received an OWT with VAC for the treatment of postoperative or recurrent pleural empyema. Two of them had a bronchial stump insufficiency BPF . Results VAC therapy ensured local control of the empyema and control of sepsis. The continuous suction up to 125 mm Hg cleaned the wound and thoracic cavity and supported the rapid healing. Additionally installation of a stable vacuum was possible in the two patients with BPF. The smaller bronchus stump fistula closed spontaneously due to the VAC therapy but the larger remained open. The direct contact of the VAC sponge did not create any air leak or bleeding from the lung or the mediastinal structures. The VAC therapy allowed a better re-expansion of remaining lung. One patient died in the late postoperative period day 47 . of multiorgan failure. In three cases VAC therapy was continued in an outpatient service and in four patients the OWT was treated with conventional wound care. After a mean time of three months the chest wall was closed in five of seven cases. However two patients rejected the closure of the OWT. After a follow-up at .

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