title: Vacuum-assisted closure of pleural empyema without classic open-window thoracostomy.
abstract: A 64-year-old man was diagnosed with complex empyema after a second course of palliative chemotherapy for metastatic lung cancer. Because of the poor general condition of the patient, the decision was made to proceed with vacuum-assisted closure (VAC) therapy of the empyema without Eloesser or Clagett open-window thoracostomy (OWT). Installation and changing of the VAC sponge were performed using the ALEXIS Wound Protector/Retractor (Applied Medical, Rancho Santa Margarita, CA), a flexible polymer membrane tube. After 10 days of VAC treatment, the pleural cavity was sterile and was closed with single stitches. Chemotherapy was resumed 1 week later.
authors.affiliation: Department of Thoracic Surgery, Hospital Barmherzige Brüder Regensburg, and Department of Thoracic Surgery, University of Regensburg, Regensburg, Germany. hans-stefan.hofmann@barmherzige-regensburg.de
authors.forename: Hans-Stefan
authors.initials: HS
authors.lastname: Hofmann
authors.forename: Rudolf
authors.initials: R
authors.lastname: Schemm
authors.forename: Christian
authors.initials: C
authors.lastname: Grosser
authors.forename: Tamas
authors.initials: T
authors.lastname: Szöke
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Sziklavari
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D016638:Critical Illness / Q000628:therapy; D016724:Empyema, Pleural / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D018570:Risk Assessment; D013907:Thoracostomy; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome