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Ann Thorac Surg. 2012 May;93(5):1741-2. doi: 10.1016/j.athoracsur.2011.12.039.

Vacuum-assisted closure of pleural empyema without classic open-window thoracostomy.

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Department of Thoracic Surgery, Hospital Barmherzige Brüder Regensburg, and Department of Thoracic Surgery, University of Regensburg, Regensburg, Germany.


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.

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