Outcomes of Delayed Chest Closure After Bilateral Lung Transplantation

Force, Seth D.; Miller, Daniel; Peláez, Andrés; Ramirez, Allan; Vega, David; Barden, Benjamin; Lawrence, E. Clinton

doi:10.1016/j.athoracsur.2006.01.050

Cited by 38 publications

(43 citation statements)

References 15 publications

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“…DCC has reported to contribute in decreasing the risk of primary graft dysfunction, leading to improved outcomes after the procedure [8]. DCC was also reported not to increase wound infections or sternal complications [9]. Actually, this is the only case with wound dehiscence in our experience among DCC procedures in 17 cases.…”

Section: Discussionmentioning

confidence: 84%

Prolonged Negative Pressure Wound Therapy Followed by Split-Thickness Skin Graft Placement for Wide Dehiscence of Clamshell Incision After Bilateral Lung Transplantation: A Case Report

Suzuki

Watanabe

Okazaki

et al. 2016

Transplantation Proceedings

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Section: Discussionmentioning

confidence: 84%

Prolonged Negative Pressure Wound Therapy Followed by Split-Thickness Skin Graft Placement for Wide Dehiscence of Clamshell Incision After Bilateral Lung Transplantation: A Case Report

Suzuki

Watanabe

Okazaki

et al. 2016

Transplantation Proceedings

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“…5 This technique may also potentially avoid use of extracorporeal life support, especially with oversized grafts with primary graft dysfunction, by stabilizing hemodynamic status and improving gas exchange. 4 The skin closure technique described here is not only cost effective but also avoids leaking of blood and soaking of dressing and offers an aesthetic look. The skin closure may have some tamponade effect, which helps formation and stabilization of clots compared with Esmarch bandage cover, which has a tendency to bulge out and move with breathing.…”

Section: Discussionmentioning

confidence: 99%

“…4 It releases compartment pressure over the lungs and at the same time keeps the lungs confined to a certain extent. It not only allows sufficient time for improving lung function and resolving edema but also prominently avoids lung volume reduction or at least quantity of the lung reduction.…”

Section: Discussionmentioning

confidence: 99%

“…Delayed chest closure may be achieved by leaving the chest open and/or stitching Esmarch bandage (a type of tourniquet) or Bogota bag over the incision. 4,5 An open chest in the postoperative period would significantly affect airway pressures needed to achieve an expected tidal volume. 3 During mechanical ventilation, the Bogota bag or Esmarch bandage may be sucked in during expiratory phase and blown out during inspiratory phase, affecting tidal volume and the effective gas exchange.…”

Section: Introductionmentioning

confidence: 99%

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Mohite

Sabashnikov

Popov

et al. 2018

Exp Clin Transplant

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Closure of the chest after lung transplant in cases of oversized grafts is often difficult. Lung volume reduction and delayed closure of the chest with Bogota bag are the only options available in such situations. Here, we propose to keep the sternum and intercostal spaces open and approximate skin over it. Once lung function improves and reperfusion-related edema recovers, the chest can be closed.

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“…This obviously correlates with the transformation of an aerated into a solid tissue structure and, at interstitial tissue level, it also relates with a shift from a sub-atmospheric to a highly positive interstitial pressure [5]. Delayed chest closure has been proposed after bilateral lung transplantation when significant bleeding/coagulopathy has occurred [59].…”

Section: Pericardial and Lung Compression Due To Lung Edemamentioning

confidence: 99%

Cardiopulmonary Consequences of Post Thoracic Surgery Pulmonary Hypertension: Cause or Consequence of Lung Edema?

Rivolta¹,

Beretta²,

Panariti

et al. 2013

J Clin Exp Cardiolog

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The major complication of post-thoracic surgery is a severe disturbance of lung extravascular water that is the main cause of morbidity and mortality and therefore still represents an unmet medical challenge. Accordingly, the need to devise novel therapies ought to go through a more thorough understanding of the pathophysiological mechanisms. This review presents an updated description of the time evolution of this process providing the pathophysiological reason for its explosive development. Despite various names ("idiopathic edema", acute lung injury-ALI, atelectasis, ARDS), a common patho-physiological pathway can be traced for respiratory dysfunction in post-operative thoracic surgery. We will present the evidence for the loss of control on the volume of extravascular lung water from the new perspective of the derangement and disorganization of interstitial proteoglycans, a family of link molecules controlling microvascular permeability and mechanical stability of the extravascular matrix. We analyze in detail specific conditions of lung water disturbance pertaining to cardiac surgery, lung transplant and lung resection surgery. In particular, we will discuss the functional link between lung edema formation and increase in pulmonary vascular resistances, and wish to develop the concept that pulmonary hypertension and right ventricle overload ought to be regarded as the consequence of a decrease in vascular bed reflecting microvessels compression in the edematous tissue both in the acute phase as well as in the fibro-proliferative repair process.

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Outcomes of Delayed Chest Closure After Bilateral Lung Transplantation

Cited by 38 publications

References 15 publications

Prolonged Negative Pressure Wound Therapy Followed by Split-Thickness Skin Graft Placement for Wide Dehiscence of Clamshell Incision After Bilateral Lung Transplantation: A Case Report

Prolonged Negative Pressure Wound Therapy Followed by Split-Thickness Skin Graft Placement for Wide Dehiscence of Clamshell Incision After Bilateral Lung Transplantation: A Case Report

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Cardiopulmonary Consequences of Post Thoracic Surgery Pulmonary Hypertension: Cause or Consequence of Lung Edema?

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