Postpneumonectomy MRSA empyema treated with vacuum therapy - case report and literature review

Postpneumonectomy empyema is one of serious complications with high mortality and lethality. In this paper, the authors describe the treatment of methicillin-resistant Staphylococcus aureus-induced postpneumonectomy empyema by vacuum therapy in a patient operated on for malignant pleural mesotheliom...

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Bibliographic Details
Published in:	Rozhledy v chirurgii Vol. 100; no. 10; p. 502
Main Authors:	Horák, P, Jágrová, K, Fulík, J, Erbenová, A, Fanta, J
Format:	Journal Article
Language:	English
Published:	Czech Republic 2021
Subjects:	Bronchial Fistula - surgery Empyema, Pleural - etiology Empyema, Pleural - surgery Humans Methicillin-Resistant Staphylococcus aureus Middle Aged Negative-Pressure Wound Therapy Pneumonectomy - adverse effects empyema malignant pleural mesothelioma pneumonectomy vacuum therapy negative pressure wound therapy Methicillin-resistant Staphylococcus aureus
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Summary:	Postpneumonectomy empyema is one of serious complications with high mortality and lethality. In this paper, the authors describe the treatment of methicillin-resistant Staphylococcus aureus-induced postpneumonectomy empyema by vacuum therapy in a patient operated on for malignant pleural mesothelioma. A 64-year-old patient was operated on at our clinic for epithelioid mesothelioma of the right pleural cavity. We performed extrapleural pneumonectomy with intraoperative hyperthermic intrathoracic chemotherapy. Seven weeks after surgery the patient was readmitted for right pleural cavity empyema caused by methicillin-resistant Staphylococcus aureus (MRSA). Following pleural cavity debridement and mesh explantation we applied vacuum therapy. In total, we performed 4 dressing changes with final application of an antibiotic solution into the pleural cavity and wound closure. The patient showed no evidence of recurrent empyema during subsequent 12-month follow-up and underwent chemotherapy. Vacuum therapy is an effective treatment of postpneumonectomy empyema in patients without a bronchopleural fistula; nevertheless, specific postpneumonectomy patient care is required.
ISSN:	0035-9351
DOI:	10.33699/PIS.2021.100.10.502-506