Preliminary Experience of Autologous Free Dermal Graft Combined With Free Myocutaneous Flap in the Treatment of Refractory Bronchopleural Fistula With Empyema
Abstract Background: To explore the effects of autologous free dermal graft combined with free myocutaneous flap on bronchopleural fistula with empyema. Methods: Two patients with refractory empyema and bronchopleural fistula were treated with autologous free dermal graft combined with free myocutaneous flap. The free dermal graft was harvested from the skin around the incision and the fistula was sutured intermittently. The lateral femoral myocutaneous flap was selected as the free flap. Using microsurgery techniques, the descending branch of the lateral femoral circumflex artery and the thoracodorsal blood vessel were anastomosed intermittently to maintain the blood supply of the myocutaneous flap. After surgery, the empyema, air leakage, and the survival of the myocutaneous flap were observed. Results: No necrosis of the myocutaneous flap was observed after surgery. There was no disease recurrence after follow-up for seven and six months, respectively. Re-examination of the chest computed tomography or magnetic resonance imaging indicated that the empyema residual cavity had disappeared. Conclusion: Autologous free dermal graft combined with free lateral femoral myocutaneous flap transplantation is effective in the treatment of patients with bronchopleural fistula with refractory chronic empyema, with satisfactory clinical effects.