title: Vacuum-assisted closure therapy in the management of lung abscess.
abstract: BACKGROUND
  Despite significant advances in the treatment of thoracic infections, complex lung abscess remains a problem in modern thoracic surgery. We describe the novel application of vacuum-assisted closure for the treatment of a lung abscess. The technical details and preliminary results are reported.
  
  
  METHODS
  After the initial failed conservative treatment of an abscess, minimally invasive surgical intervention was performed with vacuum-assisted closure. The vacuum sponges were inserted in the abscess cavity at the most proximal point to the pleural surface. The intercostal space of the chest wall above the entering place was secured by a soft tissue retractor. The level of suction was initially set to 100 mm Hg, with a maximum suction of 125 mm Hg. The sponge was changed once on the 3rd postoperative day.
  
  
  RESULTS
  The abscess cavity was rapidly cleaned and decreased in size. The mini-thoracotomy could be closed on the 9th postoperative day. Closure of the cavity was simple, without any short- or long-term treatment failure. This technique reduced the trauma associated with the procedure. The patient was discharged on the 11th postoperative day.
  
  
  CONCLUSIONS
  Vacuum-assisted closure systems should be considered for widespread use as an alternative option for the treatment of complicated pulmonary abscess in elderly, debilitated, immunocompromised patients after failed conservative treatment.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Sziklavari
authors.forename: Michael
authors.initials: M
authors.lastname: Ried
authors.forename: Hans-Stefan
authors.initials: HS
authors.lastname: Hofmann
mesh_terms: D000328:Adult; D006801:Humans; D008169:Lung Abscess / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D011182:Postoperative Care / Q000379:methods; D013396:Suction; D013908:Thoracotomy / Q000379:methods; D014057:Tomography, X-Ray Computed