scholarly journals Effect of Circumference of Open Window Thoracostomy on Chest Wall Closure, Pleural Cavity Clearance, and Lung Expansion

Cureus ◽  
2021 ◽  
Author(s):  
Shagufta Nasreen ◽  
Nadir Ali ◽  
Tanveer Ahmad ◽  
Misauq Mazcuri ◽  
Ambreen Abid ◽  
...  
Keyword(s):  
Chest Wall ◽  
Pleural Cavity ◽  
Lung Expansion ◽  
Open Window ◽  
Open Window Thoracostomy

scholarly journals Manual on wound care after open-window thoracostomy

2020 ◽  
Author(s):  
Alcione de Jesus Gonçalves Santana ◽  
Leila Blanes ◽  
Christiane Steponavicius Sobral ◽  
Lydia Masako Ferreira
Keyword(s):  
Health Professionals ◽  
Content Validity ◽  
Healthcare Professionals ◽  
Pleural Cavity ◽  
Wound Care ◽  
Layout Design ◽  
Thoracic Cavity ◽  
Validity Index ◽  
Open Window ◽  
Open Window Thoracostomy

Objective: To produce and validate a manual on wound care after open-window thoracostomy for healthcare professionals. Methods: This is an experience report. Initially, articles in Portuguese, Spanish and English were selected from 2010 to 2018 in the Cochrane, SciELO, LILACS, PubMed and Google Academic databases and search sites for the development of the material. The following descriptors were used: “thoracotomy”, “thoracostomies”, “thoracic cavity”, “pleura”, “pleural cavity”, “injuries and lesions”. After consultation, the text was prepared, followed by illustrations and layout design. The completed manuscript was sent to experts for validation. The content validity index (CVI) was used to validate the manual. Results: The manual developed has thirty-six pages and seven chapters with the following themes: introduction, wound care after open-window thoracostomy, wound cleansing/debridement, dressings, care record, final considerations, and bibliography. Conclusion: It was possible to develop and validate a manual on wound care after open-window thoracostomy for the consultation of health professionals.

scholarly journals Abdominal visceral hernia through a chest wall defect secondary to open-window thoracostomy

2006 ◽  
Vol 29 (4) ◽  
pp. 601-601
Author(s):  
Luca Ampollini ◽  
Antonio Bobbio ◽  
Leonardo Cattelani ◽  
Paolo Carbognani
Keyword(s):  
Chest Wall ◽  
Wall Defect ◽  
Chest Wall Defect ◽  
Open Window ◽  
Open Window Thoracostomy

scholarly journals Open-window thoracostomy and microvascular muscle flap for severe intrathoracic infection around aortic prosthetic graft

2005 ◽  
Vol 129 (5) ◽  
pp. 1182-1184 ◽  
Author(s):  
Nai-Chen Cheng ◽  
Jiun Hsu ◽  
Jing-Shing Chen ◽  
Hao-Chih Tai ◽  
Hsi-Yu Yu
Keyword(s):  
Muscle Flap ◽  
Prosthetic Graft ◽  
Open Window ◽  
Open Window Thoracostomy

FEATURES OF PLEURAL CAVITY DRAINAGE IN PATIENTS WITH ACUTE NONSPECIFIC PLEURAL EMPYEMA

2020 ◽  
pp. 39-42
Author(s):  
D. V. Minukhin ◽  
O. I. Tsyvenko ◽  
A. Yu. Korolevska ◽  
L. G. Tarasenko ◽  
D. Yu. Melnyk ◽  
...  
Keyword(s):  
Chest Wall ◽  
Pleural Cavity ◽  
Pleural Empyema ◽  
Pleural Drainage ◽  
Main Method ◽  
Second Stage ◽  
The Third ◽  
Third Stage ◽  
Minor Surgery ◽  
Surgical Manipulation

Most authors considered pleural cavity drainage to be the main method of treatment of acute pleural empyema using minor surgery. Despite the simplicity of drainage of the pleural cavity, the number of complications after this surgical manipulation, according to the reports of some authors, varies from 3 to 8 %. The complications of pleural drainage in the patients with acute nonspecific pleural empyema have been studied and the technique of pleural drainage "blindly" has been introduced, which allows drainage to be located along the chest wall. At the first stage of the four−stage study, the complications of pleural drainage in 38 patients with acute nonspecific pleural empyema were analyzed, at the second stage a device for drainage of the pleural cavity "blindly" was developed to place drainage in parallel to the chest wall, at the third stage patients were tested; on IV −− drainage of the pleural cavity of 34 patients was performed according to the proposed method. The reason for the development of drainage complications in the pleural cavity of patients with acute pleural empyema was the inadequate location of drainage in the pleural cavity, drainage of the pleural cavity was carried out in general hospitals without the use of thoracoscopic equipment. Curved thoracoport with trocar for a blind drainage of the pleural cavity "blindly" was developed and introduced into clinical practice. This technique eliminates the involuntary location of the drainage in the pleural cavity, installing it along the chest wall, and is safe. Complications associated with drainage of the pleural cavity according to the developed method using a curved thoracoport with a trocar, inadequate location of drainage, were not observed in patients. Key words: acute pleural empyema, pleural cavity drainage, curved trocar.

Regional coupling between chest wall and lung expansion during HFV: a positron imaging study

1993 ◽  
Vol 74 (5) ◽  
pp. 2242-2252 ◽  
Author(s):  
J. G. Venegas ◽  
K. Tsuzaki ◽  
B. J. Fox ◽  
B. A. Simon ◽  
C. A. Hales
Keyword(s):  
Chest Wall ◽  
Lung Volume ◽  
Gas Transport ◽  
Regional Scale ◽  
Regional Distribution ◽  
Imaging Study ◽  
High Frequency Ventilation ◽  
Rib Cage ◽  
Lung Expansion ◽  
Frequency Ventilation

Apparently conflicting differences between the regional chest wall motion and gas transport have been observed during high-frequency ventilation (HFV). To elucidate the mechanism responsible for such differences, a positron imaging technique capable of assessing dynamic chest wall volumetric expansion, regional lung volume, and regional gas transport was developed. Anesthetized supine dogs were studied at ventilatory frequencies (f) ranging from 1 to 15 Hz and eucapnic tidal volumes. The regional distribution of mean lung volume was found to be independent of f, but the apex-to-base ratio of regional chest wall expansion favored the lung bases at low f and became more homogeneous at higher f. Regional gas transport per unit of lung volume, assessed from washout maneuvers, was homogeneous at 1 Hz, favored the bases progressively as f increased to 9 Hz, and returned to homogeneity at 15 Hz. Interregional asynchrony (pendelluft) and right-to-left differences were small at this large regional scale. Analysis of the data at a higher spatial resolution showed that the motion of the diaphragm relative to the excursions of the rib cage decreased as f increased. These differences from apex to base in regional chest wall expansion and gas transport were consistent with a simple model including lung, rib cage, and diaphragm regional impedances and a viscous coupling between lungs and chest wall caused by the relative sliding between pleural surfaces. To further test this model, we studied five additional animals under open chest conditions. These studies resulted in a homogeneous and f-independent regional gas transport. We conclude that the apex-to-base distribution of gas transport observed during HFV is not caused by intrinsic lung heterogeneity but rather is a result of chest wall expansion dynamics and its coupling to the lung.

Abdominal distension alters regional pleural pressures and chest wall mechanics in pigs in vivo

1991 ◽  
Vol 70 (6) ◽  
pp. 2611-2618 ◽  
Author(s):  
T. Mutoh ◽  
W. J. Lamm ◽  
L. J. Embree ◽  
J. Hildebrandt ◽  
R. K. Albert
Keyword(s):  
Chest Wall ◽  
Respiratory System ◽  
Functional Residual Capacity ◽  
Total Lung Capacity ◽  
Abdominal Cavity ◽  
Abdominal Distension ◽  
Abdominal Pressure ◽  
Lung Capacity ◽  
Lung Expansion ◽  
Residual Capacity

Abdominal distension (AD) occurs in pregnancy and is also commonly seen in patients with ascites from various causes. Because the abdomen forms part of the "chest wall," the purpose of this study was to clarify the effects of AD on ventilatory mechanics. Airway pressure, four (vertical) regional pleural pressures, and abdominal pressure were measured in five anesthetized, paralyzed, and ventilated upright pigs. The effects of AD on the lung and chest wall were studied by inflating a liquid-filled balloon placed in the abdominal cavity. Respiratory system, chest wall, and lung pressure-volume (PV) relationships were measured on deflation from total lung capacity to residual volume, as well as in the tidal breathing range, before and 15 min after abdominal pressure was raised. Increasing abdominal pressure from 3 to 15 cmH2O decreased total lung capacity and functional residual capacity by approximately 40% and shifted the respiratory system and chest wall PV curves downward and to the right. Much smaller downward shifts in lung deflation curves were seen, with no change in the transdiaphragmatic PV relationship. All regional pleural pressures increased (became less negative) and, in the dependent region, approached 0 cmH2O at functional residual capacity. Tidal compliances of the respiratory system, chest wall, and lung were decreased 43, 42, and 48%, respectively. AD markedly alters respiratory system mechanics primarily by "stiffening" the diaphragm/abdomen part of the chest wall and secondarily by restricting lung expansion, thus shifting the lung PV curve as seen after chest strapping. The less negative pleural pressures in the dependent lung regions suggest that nonuniformities of ventilation could also be accentuated and gas exchange impaired by AD.

Open Window Thoracostomy for Pleural Empyema Complicating Partial Lung Resection

2009 ◽  
Vol 87 (3) ◽  
pp. 869-873 ◽  
Author(s):  
Fabio Massera ◽  
Mario Robustellini ◽  
Claudio Della Pona ◽  
Gerolamo Rossi ◽  
Adriano Rizzi ◽  
...  
Keyword(s):  
Lung Resection ◽  
Pleural Empyema ◽  
Open Window ◽  
Open Window Thoracostomy ◽  
Partial Lung Resection

Video-Thoracoscopic Management of Postpneumonectomy Empyema

2018 ◽  
Vol 66 (08) ◽  
pp. 701-706 ◽  
Author(s):  
Lorenzo Spaggiari ◽  
Domenico Galetta
Keyword(s):  
Median Time ◽  
Thoracoscopic Surgery ◽  
Bronchopleural Fistula ◽  
Nonsmall Cell Lung Cancer ◽  
Invasive Approach ◽  
Thoracoscopic Approach ◽  
Open Window ◽  
Open Window Thoracostomy ◽  
A Minor

Background Postpneumonectomy empyema (PPE) is a serious complication even when it is not associated with bronchopleural fistula (BPF). Besides irrigation, an aggressive treatment is usually applied for removing infected material. However, a minimally invasive approach might achieve satisfactory results in selected patients. Methods We retrospectively identified 18 patients presenting with PPE receiving video-thoracoscopic approach. Of these 18 patients, pneumonectomy was performed for nonsmall cell lung cancer in 15 cases, for mesothelioma in 2, and for trauma in 1 case. There were 14 males and 4 females, (mean age, 62 years; range, 44–73 days). Empyema was confirmed by thoracentesis and bacteriological examination. All patients had immediate chest tube drainage and underwent thoracoscopic debridement of the empyema. Fifteen patients had no proven BPF; two had suspicious BPF, and one had a minor (<3 mm) BPF. Results Median time from pneumonectomy to empyema diagnosis was 129 days (range, 7–6205 days). Median time from drain position to video-assisted thoracoscopic surgery (VATS) procedure was 10 days (range, 2–78 days). A bacterium was isolated in 13 cases (72.2%). There was no mortality and no morbidity related to the procedure. The average duration of thoracoscopic debridement was 56 minutes (range, 40–90 minutes). Median postoperative stay was 7 days (range, 6–18 days). Only in one patient an open-window thoracostomy was performed. Median follow-up of the 18 patients receiving thoracoscopy was 41.5 months (range, 1–78 months). None had recurrent empyema. The patient with a minor BPF remained asymptomatic and is doing well at 48 months follow-up. Conclusions Thoracoscopy might be a valid approach for patients presenting with PPE with or without minimal BPF. Video-thoracoscopic debridement of postpneumonectomy space is an efficient method to treat PPE.

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