PDF(Pubmed)
Abstract：
BACKGROUND: Among a cohort of patients who underwent chest wall resection and reconstruction by rigid prosthesis, 6% required removal of the prosthesis, and in 80% of these cases the indication for prosthesis removal was infection. Although artificial prosthesis removal is the primary approach in such cases of infection, the usefulness of vacuum-assisted closure (VAC) has also been reported.
METHODS: A 64-year-old man with diabetes mellitus underwent right middle and lower lobectomy with chest wall (3rd to 5th rib) resection and lymph node dissection because of lung squamous cell carcinoma. The chest wall defect was reconstructed by an expanded polytetrafluoroethylene (PTFE) sheet. Three months after surgery, the patient developed an abscess in the chest wall around the PTFE sheet. We performed debridement and switched to VAC therapy 2 weeks after starting continuous drainage of the abscess in the chest wall. The space around the PTFE sheet gradually decreased, and formation of wound granulation progressed. We performed wound closure 6 weeks after starting VAC therapy, and the patient was discharged 67 days after hospitalization.
CONCLUSIONS: We experienced a case of chest wall reconstruction infection after surgery for non-small cell lung cancer that was successfully treated by VAC therapy without removal of the prosthesis. Although removal of an infectious artificial prosthesis can be avoided by application of VAC therapy, perioperative management to prevent surgical site infection is considered essential.
METHODS: A 64-year-old man with diabetes mellitus underwent right middle and lower lobectomy with chest wall (3rd to 5th rib) resection and lymph node dissection because of lung squamous cell carcinoma. The chest wall defect was reconstructed by an expanded polytetrafluoroethylene (PTFE) sheet. Three months after surgery, the patient developed an abscess in the chest wall around the PTFE sheet. We performed debridement and switched to VAC therapy 2 weeks after starting continuous drainage of the abscess in the chest wall. The space around the PTFE sheet gradually decreased, and formation of wound granulation progressed. We performed wound closure 6 weeks after starting VAC therapy, and the patient was discharged 67 days after hospitalization.
CONCLUSIONS: We experienced a case of chest wall reconstruction infection after surgery for non-small cell lung cancer that was successfully treated by VAC therapy without removal of the prosthesis. Although removal of an infectious artificial prosthesis can be avoided by application of VAC therapy, perioperative management to prevent surgical site infection is considered essential.
摘要：
背景：在接受刚性假体胸壁切除和重建的患者队列中，6%需要移除假体，在这些病例中，80％的假体移除指征是感染。尽管人工假体切除是此类感染病例的主要方法，真空辅助关闭(VAC)的有用性也有报道.
方法：一名64岁的糖尿病患者，因肺鳞癌而接受了右中下叶切除，胸壁（第3至第5肋）切除和淋巴结清扫术。胸壁缺损由膨胀聚四氟乙烯（PTFE）片重建。手术三个月后,患者在PTFE片周围的胸壁出现脓肿。在开始连续引流胸壁脓肿2周后，我们进行了清创术并改用VAC治疗。PTFE片材周围的空间逐渐减小，伤口肉芽的形成进展。我们在开始VAC治疗后6周进行了伤口闭合，住院67天后出院。
结论：我们经历了1例非小细胞肺癌手术后胸壁重建感染病例，该病例在未移除假体的情况下通过VAC治疗成功治疗。尽管通过应用VAC治疗可以避免去除感染性人工假体，预防手术部位感染的围手术期管理被认为是至关重要的.
方法：一名64岁的糖尿病患者，因肺鳞癌而接受了右中下叶切除，胸壁（第3至第5肋）切除和淋巴结清扫术。胸壁缺损由膨胀聚四氟乙烯（PTFE）片重建。手术三个月后,患者在PTFE片周围的胸壁出现脓肿。在开始连续引流胸壁脓肿2周后，我们进行了清创术并改用VAC治疗。PTFE片材周围的空间逐渐减小，伤口肉芽的形成进展。我们在开始VAC治疗后6周进行了伤口闭合，住院67天后出院。
结论：我们经历了1例非小细胞肺癌手术后胸壁重建感染病例，该病例在未移除假体的情况下通过VAC治疗成功治疗。尽管通过应用VAC治疗可以避免去除感染性人工假体，预防手术部位感染的围手术期管理被认为是至关重要的.
