Treatment of thoracic wounds with adapted vacuum therapy

Abstract

This is a report of seven cases of infected thoracic wounds treated with an adapted low-cost vacuum therapy in the Thoracic Surgery Unit of Santa Marcelina Hospital. The vacuum system used was designed and adapted to our hospital due to financial limitations on the acquisition of commercial kits. The vacuum-assisted closure kit used in this study consisted of chlorhexidine sponges (which are usually used for antisepsis of the surgical team), a 16F nasogastric tube, and two sterile adhesive films (OPSITE) for surgical field reinforcement. The mean duration of vacuum therapy was 13.4 days (range, 10-20 days), with an average of three dressing changes (range, 1-5). After treatment with vacuum-assisted closure, three wounds (3/7) were closed with simple primary sutures, one of the lesions (1/7) was closed by muscle flap rotation, and three wounds (3/7) healed by second intention. This adapted vacuum therapy was safe and easy to apply in our institution, including its use in patients with thoracostomies.

Experience of using vacuum-therapy in thoracic surgery

“…Висока ефективність використання вакуум-терапії (Vacuum-assisted closure, VAC-терапії) у лікуванні гнійних та трофічних ран різної локалізації наразі не викликає сумніву. Водночас використання VAC-терапії є досить новим і прогресивним напрямком торакальної хірургії, що дозволяє покращити результати лікування хворих [8,9]. VAC-терапія розглядається як альтернатива при гнійних ускладненнях з боку післяопераційної рани при різних видах торакальних операцій.…”

Is closed thoracic drainage tube necessary for minimally invasive thoracoscopic-esophagectomy?

“…including postoperative pain and tube related complications, which might reduce the patients' satisfaction and delay the perioperative recovery (6,7). Thus, it comes a question about the necessity of CTDT after esophagectomy.…”