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Modified blowhole skin incision using negative pressure wound therapy in the treatment of ventilator-related severe subcutaneous emphysema.

Authors
 Bong Soo Son  ;  Sungsoo Lee  ;  Woo Hyun Cho  ;  Jung Joo Hwang  ;  Kil Dong Kim  ;  Do Hyung Kim 
Citation
 INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, Vol.19(6) : 904-907, 2014 
Journal Title
 INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY 
ISSN
 1569-9293 
Issue Date
2014
MeSH
Adult ; Aged ; Aged, 80 and over ; Decompression, Surgical/adverse effects ; Decompression, Surgical/methods* ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy*/adverse effects ; Respiration, Artificial/adverse effects* ; Respiration, Artificial/instrumentation ; Retrospective Studies ; Severity of Illness Index ; Subcutaneous Emphysema/diagnosis ; Subcutaneous Emphysema/etiology ; Subcutaneous Emphysema/surgery* ; Time Factors ; Treatment Outcome ; Ventilators, Mechanical/adverse effects*
Keywords
Mechanical ventilation ; Negative pressure wound therapy ; Subcutaneous emphysema
Abstract
OBJECTIVES: A 2-3-cm blowhole incision in the supraclavicular or infraclavicular area is widely used to eliminate the presence of subcutaneous air in cases of life-threatening subcutaneous emphysema (SE). However, when the patient is supported by mechanical ventilation, it is difficult to eliminate completely such air because mechanical ventilation leads consistently to the formation of large amounts of air. To overcome this, we applied negative pressure wound therapy (NPWT) along with blowhole incisions for the treatment of severe SE. METHODS: To evaluate the feasibility of NPWT, we retrospectively analysed the clinical outcomes of 10 patients who developed severe SE during ventilator care and were treated with a modified blowhole incision using NPWT from January 2009 to November 2013. RESULTS: All patients showed immediate improvement in SE after NPWT, and no symptom aggravation occurred after NPWT. The mean duration of NPWT was 7.5 ± 5.1 (range, 3-14) days, and the mean number of dressing changes was 1.5 ± 0.7 (range, 1-2). There were no blowhole-incision-related wound infections or any other complications. CONCLUSIONS: While it is not necessary to apply a blowhole incision with NPWT in all cases of SE, this therapy can be helpful for patients with severe SE associated with mechanical ventilation requiring rapid decompression.
Files in This Item:
T201405810.pdf Download
DOI
10.1093/icvts/ivu287
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Sung Soo(이성수) ORCID logo https://orcid.org/0000-0001-8998-9510
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138919
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