title: Massive spontaneous subcutaneous emphysema. Acute management with infraclavicular "blow holes".
abstract: Four patients who recently developed massive spontaneous subcutaneous emphysema in our intensive care unit are reported. No obviously remediable intrathoracic process was found in any of these patients. The acute physiologic impairment and grotesque cosmetic deformity were immediately alleviated by making bilateral 3-cm infraclavicular incisions down to the pectoralis fascia. These acutely decompressed the progressive subcutaneous dissection and each patient's subcutaneous emphysema resolved without any additional invasive therapy.
authors.affiliation: Division of Cardiothoracic Surgery, University of Pittsburgh Medical Center.
authors.forename: D B
authors.initials: DB
authors.lastname: Herlan
authors.forename: R J
authors.initials: RJ
authors.lastname: Landreneau
authors.forename: P F
authors.initials: PF
authors.lastname: Ferson
mesh_terms: D000208:Acute Disease; D000328:Adult; D000772:Anesthesia, Local; D002968:Clavicle; D003422:Critical Care; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D013352:Subcutaneous Emphysema / Q000209:etiology / Q000601:surgery*