PDF herunterladen
CC BY-NC-ND 4.0 · Indian J Plast Surg 2021; 54(02): 211-214
DOI: 10.1055/s-0041-1729502
Case Report

Temporary Extrathoracic Vacuum Therapy Splint in Chest Wall Reconstruction

Srikanth Vasudevan
1   Department of Plastic and Reconstructive Surgery, Manipal Hospital, Bangalore, India
,
Shriram Vaidya
2   Department of Critical Care Medicine, Manipal Hospital, Bangalore, India
,
Ritu Baath S.
1   Department of Plastic and Reconstructive Surgery, Manipal Hospital, Bangalore, India
,
Ashok Basur C.
1   Department of Plastic and Reconstructive Surgery, Manipal Hospital, Bangalore, India
,
Anantheswar Yellambalase N.
1   Department of Plastic and Reconstructive Surgery, Manipal Hospital, Bangalore, India
,
Sudarshan Reddy Nagireddy
1   Department of Plastic and Reconstructive Surgery, Manipal Hospital, Bangalore, India
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Background Paradoxical respiration is a sinister consequence of bony chest cage defects which can persist even post chest wall reconstruction. It leads to prolonged dependence on mechanical ventilation postoperatively, thereby delaying recovery. Methods Negative pressure wound therapy (NPWT) was applied in early postoperative period to a patient with chest wall defect reconstructed with folded prolene mesh and free anterolateral thigh flap. Arterial blood gas (ABG), fraction of inspired oxygen (FiO2), peak end expiratory pressure (PEEP), oxygen saturation (SpO2), and blood pressure (BP) readings pre and post NPWT application were compared. Results There was marked improvement in the breathing mechanics and related parameters post NPWT application over the flap. Conclusions Negative extrathoracic pressure in the form of a temporary splint can enable early weaning off the ventilator and a smoother postoperative recovery in reconstructed chest wall defects.

Keywords

chest wall reconstruction - negative pressure wound therapy - paradoxical respiration


Publikationsverlauf

Artikel online veröffentlicht:
15. Juni 2021

© 2021. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Winge R, Berg JO, Albret R, Krag C. VAC for external fixation of flail chest. Clin Pract 2012; 2 (03) e65
    CrossrefPubMedSuche in Google Scholar
  • 2 Sanna S, Brandolini J, Pardolesi A. et al. Materials and techniques in chest wall reconstruction: a review. J Vis Surg 2017; 3: 95
    CrossrefPubMedSuche in Google Scholar
  • 3 Aghajanzadeh M, Alavy A, Taskindost M, Pourrasouly Z, Aghajanzadeh G, Massahnia S. Results of chest wall resection and reconstruction in 162 patients with benign and malignant chest wall disease. J Thorac Dis 2010; 2 (02) 81-85
    PubMedSuche in Google Scholar
  • 4 McCormack PM. Use of prosthetic materials in chest-wall reconstruction. Assets and liabilities. Surg Clin North Am 1989; 69 (05) 965-976
    CrossrefPubMedSuche in Google Scholar
  • 5 Novoa N, Alcaide J, Gomez Hernández M, Fuentes M, Goñi E, Jimenez Lopez M. Chest wall—reconstruction: yesterday, today and the future. Shanghai Chest 2019; 3: 1-9
    CrossrefSuche in Google Scholar
  • 6 Harada K, Saoyama N, Izumi K, Hamaguchi N, Sasaki M, Inoue K. Experimental pendulum air in the flail chest. Jpn J Surg 1983; 13 (03) 219-226
    CrossrefPubMedSuche in Google Scholar
  • 7 Krug E, Berg L, Lee C. et al. International Expert Panel on Negative Pressure Wound Therapy [NPWT-EP]. Evidence-based recommendations for the use of negative pressure wound therapy in traumatic wounds and reconstructive surgery: steps towards an international consensus. Injury 2011; 42 (Suppl. 01) S1-S12
    CrossrefPubMedSuche in Google Scholar
  • 8 Vaienti L, Gazzola R, Benanti E. et al. Failure by congestion of pedicled and free flaps for reconstruction of lower limbs after trauma: the role of negative-pressure wound therapy. J Orthop Traumatol 2013; 14 (03) 213-217
    CrossrefPubMedSuche in Google Scholar
  • 9 Chim H, Zoghbi Y, Nugent AG, Kassira W, Askari M, Salgado CJ. Immediate application of vacuum assisted closure dressing over free muscle flaps in the lower extremity does not compromise flap survival and results in decreased flap thickness. Arch Plast Surg 2018; 45 (01) 45-50
    Thieme ConnectPubMedSuche in Google Scholar
  • 10 Yu P, Yu N, Yang X, Jin X, Lu H, Qi Z. Clinical efficacy and safety of negative-pressure wound therapy on flaps: a systematic review. J Reconstr Microsurg 2017; 33 (05) 358-366
    Thieme ConnectPubMedSuche in Google Scholar
  • 11 Opoku-Agyeman JL, Matera DV, Simone JE, Behnam AB. Flap viability after direct immediate application of negative pressure wound therapy on free flaps: a systematic review and pooled analysis of reported outcomes. Journal of Reconstructive Microsurgery Open 2019; 04 (02) e77-e82
    Thieme ConnectSuche in Google Scholar