Intrathoracic free musculocutaneous flap after open-window thoracostomy for chronic empyema.
An 85-year-old man was suffering from right pyothorax caused by methicillin-resistant staphylococcus aureus (MRSA). The empyema cavity was closed by intrathoracic implantation of a free rectus abdominis musculocutaneous (MC) flap using microvascular surgery 2 months after open-window thoracostomy (OWT). Compared with a pedicled MC flap, a free flap has the advantage that it can close a larger empyema cavity since the whole flap can be inserted into the cavity. Although the use of a free MC flap requires a two-stage operation, this method is believed to be more successful for controlling chronic empyema than any other established procedure, including decortication, thoracoplasty or pleuropneumonectomy.
Shimizu
J
J
Department of Surgery, Saiseikai Kanazawa Hospital, Japan. azalea-432@mvj.biglobe.ne.jp
Kinoshite
T
T
Tatsuzawa
Y
Y
Kawaura
Y
Y
Ishikura
N
N
Oda
M
M
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D016724:Empyema, Pleural / Q000601:surgery*; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000601:surgery*; D013524:Surgical Flaps; D013907:Thoracostomy