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      • Record: found
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      Postpneumonectomy Empyema in the Presence of COVID-19 Pneumonia after Non-COVID-19 ARDS

      case-report

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          Abstract

          Development of pleural empyema with or without bronchopleural fistula following pneumonectomy presents a major complication with a mortality of 10 to 20%. The surgical goals of bronchopleural fistula treatment are infection control, pus drainage, and lung re-expansion. The main goal is closure of the fistula. This can be achieved with various surgical methods, such as the Clagett or accelerated Weder procedure, omentoplasty, or a transpericardial approach, according to Abruzzini. We present the case of a 58-year-old patient with pleural empyema within the postpneumonectomy cavity in the presence of severe COVID-19 pneumonia after non-COVID-19 acute respiratory distress syndrome (ARDS) and extracorporeal membrane oxygenation (ECMO) therapy. The patient had undergone right-sided pneumonectomy for destroyed lung syndrome after invasive pulmonary aspergillosis

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          Topical negative pressure for treating chronic wounds.

          Dirk T Ubbink, Stijn Joël Westerbos, Debra Evans … (2008)
          Chronic wounds mainly affect the elderly and those with multiple health problems. Despite the use of modern dressings, some of these wounds take a long time to heal, fail to heal, or recur, causing significant pain and discomfort to the person and cost to health services. Topical negative pressure (TNP) is used to promote healing of surgical wounds by using suction to drain excess fluid from wounds. To assess the effects of TNP on chronic wound healing. For this second update of this review we searched the Cochrane Wounds Group Specialised Register (December 2007), The Cochrane Central Register of Controlled Trials (CENTRAL) - The Cochrane Library Issue 4, 2007, Ovid MEDLINE - 1950 to November Week 2 2007, Ovid EMBASE - 1982 to 2007 Week 50 and Ovid CINAHL - 1980 to December Week 1 2007. In addition, we contacted authors, companies, manufacturers, and distributors to identify relevant trials and information. All randomised controlled trials which evaluated the effects of TNP on people with chronic wounds. Selection of the trials, quality assessment, data abstraction, and data synthesis were done by two authors independently. Disagreements were solved by discussion. Two trials were included in the original review. A further five trials were included in this second update resulting in a total of seven trials involving 205 participants. The seven trials compared TNP with five different comparator treatments. Four trials compared TNP with gauze soaked in either 0.9% saline or Ringer's solution. The other three trials compared TNP with hydrocolloid gel plus gauze, a treatment package comprising papain-urea topical treatment, and cadexomer iodine or hydrocolloid, hydrogels, alginate and foam. These data do not show that TNP significantly increases the healing rate of chronic wounds compared with comparators. Data on secondary outcomes such as infection rate, quality of life, oedema, hospitalisation and bacterial load were not reported. Trials comparing TNP with alternative treatments for chronic wounds have methodological flaws and data do demonstrate a beneficial effect of TNP on wound healing however more, better quality research is needed.
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            The role of topical antibiotics used as prophylaxis in surgical site infection prevention.

            H Humphreys, C Collins, Arnold Hill … (2011)
            Compared with systemic antibiotic therapy, the topical or local delivery of an antibiotic has many potential advantages. However, local antibiotics at the surgical site have received very limited approval in any of the surgical prophylaxis consensus guidelines that we are aware of. A review of the literature was carried out through searches of peer-reviewed publications in PubMed in the English language over a 30 year period between January 1980 and May 2010. Both retrospective and prospective studies were included, as well as meta-analyses. With regard to defining 'topical' or 'local' antibiotic application, the application of an antibiotic solution to the surgical site intraoperatively or immediately post-operatively was included. A number of surgical procedures have been shown to significantly benefit from perioperative topical prophylaxis, e.g. joint arthroplasty, cataract surgery and, possibly, breast augmentation. In obese patients undergoing abdominal surgery, topical surgical prophylaxis is also proven to be beneficial. The selective use of topical antibiotics as surgical prophylaxis is justified for specific procedures, such as joint arthroplasty, cataract surgery and, possibly, breast augmentation. In selective cases, such as obese patients undergoing abdominal surgery, topical surgical prophylaxis is also proven to be beneficial. Apart from these specific indications, the evidence for use of topical antibiotics in surgery is lacking in conclusive randomized controlled trials.
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              [Pleural empyema - treatment strategies in light of etiology].

              E Hecker, H C Hecker, K A Hecker (2013)
              The variety of strategies in the treatment of parapneumonic pleural empyema demonstrates the ambiguity for the method of choice. Parapneumonic pleural empyema has been classified into different stages and classes. While the American Thoracic Society (ATS) classification is based on the natural course of the disease, or according to the radiological, physical and biochemical characteristics respectively, the American College of Chest Physicians (ACCP) has categorized the patients with pleural empyema according to the risk of a poor outcome. The British Thoracic Society (BTS) developed a treatment algorithm based on a systematic review of peer-reviewed literature. With regard to this classification the management of parapneumonic and postoperative pleural empyema is based on the stage of the disease. Therapeutic strategies include chest tube alone, chest tube with fibrinolysis, thoracoscopic debridement and decortication in open or minimally invasive techniques, closed empyemectomy, or treatment with thoracomyoplasty, open window treatment or vacuum clothing with negative pressure. The different conservative and operative therapeutic possibilities determinate the central treatment function of thoracic surgery.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Thorac Cardiovasc Surg Rep
                Journal ID (iso-abbrev): Thorac Cardiovasc Surg Rep
                Journal ID (doi): 10.1055/s-00024355
                Title: The Thoracic and Cardiovascular Surgeon Reports
                Publisher: Georg Thieme Verlag KG (Rüdigerstraße 14, 70469 Stuttgart, Germany )
                ISSN (Print): 2194-7635
                ISSN (Electronic): 2194-7643
                Publication date (Electronic): 03 August 2023
                Publication date Collection: January 2023
                Publication date PMC-release: 1 August 2023
                Volume: 12
                Issue: 1
                Pages: e51-e53
                Affiliations
                [1 ]Department of Thoracic and Cardiovascular surgery, Faculty of medicine, Clinic of university, Eberhard-Karls-University Tuebingen, Tuebingen, Baden-Württemberg, Germany
                [2 ]Department of Thoracic and Cardiovascular Surgery, Clinic of University, Tuebingen, Baden Württemberg, Germany
                Author notes
                Address for correspondence Veronika Leneis Faculty of Medicine, Eberhard-Karls-University Isolde-Kurz-Strasse 28, 84032 LandshutGermany veronika.leneis@ 123456student.uni-tuebingen.de
                Article
                Publisher ID: TCSR-11-2022-0455-CRT
                DOI: 10.1055/s-0043-1771197
                PMC ID: 10411203
                SO-VID: a774a3b0-96d7-48a1-9cde-d58954bc7e35
                Copyright © The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ )
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

                History
                Date received : 14 November 2022
                Date accepted : 12 December 2022
                Categories
                Subject: Case Report: Thoracic

                Keywords: pleural empyema,pyothorax,sars covid-19 infection,pneumonectomy,aspergillosis,bronchial stump insufficiency
                Data availability:
                Keywords: pleural empyema, pyothorax, sars covid-19 infection, pneumonectomy, aspergillosis, bronchial stump insufficiency

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