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New Technology

Invited Commentary

Cardiothoracic Surgery, Southern Illinois University School of Medicine, PO Box 19638, 800 N Rutledge, Rm D319, Springfield, IL 62794-9638

(Email: shazelrigg{at}siumed.edu).

Empyemas that require treatment more extensive than antibiotics and simple drainage (thoracentesis or chest tube) present many clinical challenges. Typically, treatment is designed to first eradicate the infection and coexisting sepsis and then later to deal with any persistent space issue as well as fistulas. Decisions pertaining to treatment of these patients is often complicated, and the patients quite sick. This article by Aru and colleagues [1] describes another potential option for treatment of these patients. They utilized vacuum-assisted closure (VAC) in 4 patients with infected intrathoracic spaces.

In all 4 cases they were successful at converting these infections to clean spaces that could then be closed. There did not appear to be any significant complications of this particular form of treatment. The use of VAC systems has been common in other areas of the body but there has been little published experience using it in the chest. This article does not answer several questions, including:

1 Is hospital stay shortened?

2 Is it cost effective?

3 Is it applicable to all intrathoracic infected spaces?

4 How much suction may be applied and how should it be altered during the hospital course. This question is especially relevant when a fistula exists.

The authors are to be congratulated for this addition to the literature. I suspect techniques using VAC will have a place in the future treatment of intrathoracic infected spaces. We look forward to more data to help address the many questions that still exist with regard to its use.

	References

Top References

 

1. Aru GM, Jew NB, Tribble CG, Merrill WH. Intrathoracic vacuum-assisted management of persistent and infected pleural spaces Ann Thorac Surg 2010;90:266-271.[Abstract/Free Full Text]

This article has been cited by other articles:

				G. Rocco, C. Cecere, A. La Rocca, N. Martucci, R. Salvi, E. Passera, and M. Cicalese Caveats in using vacuum-assisted closure for post-pneumonectomy empyema Eur J Cardiothorac Surg, May 1, 2012; 41(5): 1069 - 1071. [Abstract] [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Stephen R. Hazelrigg Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hazelrigg, S. R. Search for Related Content PubMed PubMed Citation Articles by Hazelrigg, S. R. Related Collections Pleura Related Article