title: Experience with Vacuum-Assisted Closure in the Management of Postpneumonectomy Empyema: An Analysis of Eight Cases.
abstract: BACKGROUND
  The treatment of postpneumonectomic empyema is challenging. The aim of this study was to test the efficacy of vacuum-assisted closure (VAC) in the treatment of patients with open window thoracostomy (OWT).
  
  
  METHODS
  Between January 2010 and April 2014, eight patients developed empyema following pneumonectomy for malignant diseases in our department and then underwent an OWT with subsequent VAC therapy; their cases were retrospectively studied. Each session of VAC therapy lasted 72 hours, and therapy was completed after approximately 6 sessions.
  
  
  RESULTS
  OWT in six patients resulted in either decreased size or complete closure after VAC treatment. Five patients had a bronchopleural fistula (BPF), which was closed either with a tracheal stent (three patients), primary suture, or omentoplasty. The BPF in one of these patients closed during VAC therapy. The treatment failed in two patients due to the microfistula becoming obvious in one and persistence of the fistula in the other.
  
  
  CONCLUSIONS
  We believe that the use of VAC in the treatment of postpneumonectomy empyema is effective, except for patients with BPF.
authors.affiliation: Department of Thoracic Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Karapinar
authors.affiliation: Department of Thoracic Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Özkan
authors.initials: Ö
authors.lastname: Saydam
authors.affiliation: Department of Thoracic Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Metin
authors.affiliation: Department of Thoracic Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Sertan
authors.initials: S
authors.lastname: Erdogan
authors.affiliation: Department of Thoracic Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Cemal
authors.initials: C
authors.lastname: Aker
authors.affiliation: Department of Thoracic Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Arik
authors.affiliation: Department of Thoracic Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Necati
authors.initials: N
authors.lastname: Citak
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016724:Empyema, Pleural / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D011013:Pneumonectomy / Q000009:adverse effects*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome