Vacuum-assisted closure for chest wall reconstruction infection caused by Streptococcus mitis after surgery of lung cancer: a case report

Springer Science and Business Media LLC
Nozomu Motono1, Takaki Mizoguchi1, Masahito Ishikawa1, Shun Iwai1, Yoshihito Iijima1, Hidetaka Uramoto1
1Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan

Tóm tắt

Abstract Background Among a cohort of patients who underwent chest wall resection and reconstruction by rigid prosthesis, 6% required removal of the prosthesis, and in 80% of these cases the indication for prosthesis removal was infection. Although artificial prosthesis removal is the primary approach in such cases of infection, the usefulness of vacuum-assisted closure (VAC) has also been reported. Case presentation A 64-year-old man with diabetes mellitus underwent right middle and lower lobectomy with chest wall (3rd to 5th rib) resection and lymph node dissection because of lung squamous cell carcinoma. The chest wall defect was reconstructed by an expanded polytetrafluoroethylene (PTFE) sheet. Three months after surgery, the patient developed an abscess in the chest wall around the PTFE sheet. We performed debridement and switched to VAC therapy 2 weeks after starting continuous drainage of the abscess in the chest wall. The space around the PTFE sheet gradually decreased, and formation of wound granulation progressed. We performed wound closure 6 weeks after starting VAC therapy, and the patient was discharged 67 days after hospitalization. Conclusions We experienced a case of chest wall reconstruction infection after surgery for non-small cell lung cancer that was successfully treated by VAC therapy without removal of the prosthesis. Although removal of an infectious artificial prosthesis can be avoided by application of VAC therapy, perioperative management to prevent surgical site infection is considered essential.

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Tài liệu tham khảo

Stoelben E, Ludwig C. Chest wall resection for lung cancer: indications and techniques. Eur J Cardiothorac Surg. 2009;35:450–6.

Loi M, Mazzella A, Desideri I, Fournel L, Hamelin FC, Icard P, et al. Chest wall resection and reconstruction for lung cancer: surgical techniques and example of integrated multimodality approach. J Thorac Dis. 2020;12:22–30.

Petrella F, Casiraghi M, Mariolo AV, Diotti C, Spaggiari L. Rigid prosthesis removal following chest wall resection and reconstruction for cancer. Shanghai Chest. 2018;2:64.

Verma H, Ktenidis K, George RK, Tripathi R. Vacuum-assisted closure therapy for vascular graft infection (Szilagyi grade III) in the groin-a 10-year multi-center experience. Int Wound J. 2015;12:317–21.

Miyake K, Sakagoshi N, Kitabayashi K. Results of graft removal and negative pressure wound therapy in management of graft infection. Int J Angiol. 2019;28:39–43.

Zhou M, Yu A, Wu G, Xia C, Hu X, Qi B. Role of different negative pressure values in the process of infected wounds treated by vacuum-assisted closure: an experimental study. Int Wound J. 2013;10:508–15.

Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. 1997;38:563–76.

O’Connor J, Kells A, Henry S, Scalea T. Vacuum-assisted closure for the treatment of complex chest wounds. Ann Thorac Surg. 2005;79:1196–2000.

Perentes JY, Abdelnour-Berchtold E, Blatter J, Lovis A, Ris HB, Krueger T, et al. Vacuum-assisted closure device for the management of infected postpneumonectomy chest cavities. J Thorac Cardiovasc Surg. 2015;149:745–50.

Gulyuz OC, Yildiz OO, Temiz G, Celilk IA, Karaoglanoglu N. The comparison of vacuum assisted closure (VAC) and conventional treatment methods in postpneumonectomy empyema cases. Ann Med Res. 2019;26:2200–5.

Işık H, İnan MS, Sapmaz E, Kavaklı K, Aran Ö, Çaylak H, et al. Vacuum-assisted closure (VAC) treatment in thoracic surgery: a single-center experience. South Clin Ist Euras. 2021;32:253–9.

Hunter JE, Teot L, Horch R, Banwell PE. Evidence-based medicine: vacuum-assisted closure in wound care management. Int Wound J. 2007;4:256–69.

Rocco G. Chest wall resection and reconstruction according to the principles of biomimesis. Semin Thorac Cardiovasc Surg. 2011;23:307–13.

Rocco G, Martucci N, Rocca AL, Manna CL, Luca GD, Fazioli F, et al. Postoperative local morbidity and the use of vacuum-assisted closure after complex chest wall reconstructions with new and conventional materials. Ann Thorac Surg. 2014;98:291–6.

Apelqvist J, Armstrong DG, Lavery LA, Boulton AJM. Resource utilization and economic costs of care based on a randomized trial of vacuum-assisted closure therapy in the treatment of diabetic foot wounds. Am J Surg. 2008;195:782–8.

Casey B 3rd, Hua D, Barton J, Chhetri B. Mitral valve endocarditis secondary to nasal irrigation use in chronic allergic rhinitis. Cureus. 2022;14: e28886.

Ceglowska K, Nowomiejska K, Kiszka A, Koss MJ, Maciejewski R, Rejdak R. Bilateral macular roth spots as a manifestation of subacute endocarditis. Case Rep Ophtalmol Med. 2015;2015: 493947.

Patri B, Roswag D, Fournier D, Travers B, Gerbaux A, Dubrisay J. Bacterial endocarditis complicating fibroplastic endocarditis: a case report. Ann Med Interne (Paris). 1980;131:375–7.

Takayanagi N, Kagiyama N, Ishiguro T, Tokunaga D, Sugita Y. Etiology and outcome of community-acquired lung abscess. Respiration. 2010;80:98–105.

Zhang B, Zhou J, Xie G, Zhang L, Zhang Y, Xu K, et al. A case of urinary tract infection caused by multidrug resistant streptococcus mitis/oralis. Infect drug resist. 2023;16:4285–8.

Cariati VP, Deng W. Atypical presentation of thoracic spondylodiscitis caused by Streptococcus mitis. BMJ Case Rep. 2014;2014:bcr2013200532.

Tu J, MacDonald M, Mansfield D. Pulmonary actinomycosis and polymicrobial empyema in a patient with ABPA and bronchocoele. Respirol Case Rep. 2022;10: e0954.

Seidelman JL, Mantyh CR, Anderson DJ. Surgical site infection prevention: a review. JAMA. 2023;329:244–52.

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