VAC® for external fixation of flail chest

Area of Science:

• Thoracic surgery
• Reconstructive surgery
• Critical care medicine

Background:

• Large anterior chest wall defects pose significant reconstruction challenges.
• Paradoxical respiration following reconstruction can impede ventilator weaning.

Observation:

• A Gore-Tex membrane and free flap were used for chest wall reconstruction.
• Application of Vacuum Assisted Closure (VAC) led to immediate chest wall stability.
• VAC application decreased the patient's need for respiratory support.

Findings:

• VAC as an adjuvant to one-stage thoracic wall reconstruction successfully eliminated paradoxical respiration.
• VAC provided temporary external fixation, improving thoracic stability and pulmonary function.
• No adverse effects on flap healing or hemodynamics were observed.

Implications:

• VAC may shorten intensive care unit (ICU) stays for patients with large thoracic wall defects.
• This approach offers a potentially valuable adjunct for managing flail chest injuries.
• External VAC application could reduce mechanical ventilation requirements in complex thoracic reconstructions.