title: Obliteration of empyema tract with deepithelialized unipedicle transverse rectus abdominis myocutaneous flap.
abstract: Four patients with chronic empyema after pneumonectomy have undergone successful obliteration of the empyema tract with a deepithelialized transverse rectus abdominis myocutaneous flap. The deepithelialized skin island has provided sufficient bulk for tract obliteration. Rotation of the skin island into the long axis of the rectus muscle has added considerable length to this flap, allowing it to reach the apex of the thoracic cavity. A recurrent loculation developed 4 months after the obliteration procedure in one patient. This was successfully treated with open pleural drainage and a second Clagett procedure. Over a mean follow-up period of 35 months, all four patients are free of further infectious sequelae. Chest roentgenograms have confirmed eradication of the tracts in all four patients.
authors.affiliation: Department of Surgery, University of Rochester, N.Y, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Serletti
authors.forename: R H
authors.initials: RH
authors.lastname: Feins
authors.forename: A J
authors.initials: AJ
authors.lastname: Carras
authors.forename: J E
authors.initials: JE
authors.lastname: Losee
authors.forename: D W
authors.initials: DW
authors.lastname: Johnstone
authors.forename: H R
authors.initials: HR
authors.lastname: Herrera
authors.forename: G L
authors.initials: GL
authors.lastname: Hicks
mesh_terms: D000368:Aged; D002908:Chronic Disease; D004322:Drainage; D016724:Empyema, Pleural / Q000000981:diagnostic imaging / Q000601:surgery*; D004848:Epithelium; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000601:surgery; D011013:Pneumonectomy / Q000009:adverse effects; D013902:Radiography, Thoracic; D017568:Rectus Abdominis / Q000637:transplantation*; D012008:Recurrence; D012086:Reoperation; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000379:methods*; D013907:Thoracostomy / Q000009:adverse effects