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Published on: October 11, 2024
822
Delayed Chest Closure With Skin Approximation After Lung Transplant in Oversized Graft
Prashant N Mohite1, Anton Sabashnikov, Aron-Frederik Popov
1From the Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust, Harefield, London, United Kingdom.
Summary
Difficult chest closure after lung transplant with oversized grafts can be managed by leaving the sternum and skin open. This approach allows for edema recovery before final closure, improving patient outcomes.
Area of Science:
- Cardiothoracic Surgery
- Transplantation Medicine
- Surgical Innovation
Background:
- Post-lung transplant chest closure is challenging with oversized grafts.
- Current methods like lung volume reduction or Bogota bags have limitations.
Observation:
- Oversized lung grafts can lead to significant chest wall tension and edema post-transplant.
- Standard closure techniques may be compromised by persistent graft swelling.
Findings:
- A novel technique involves leaving the sternum and intercostal spaces open, with only skin approximation.
- This delayed closure strategy accommodates graft edema and allows for eventual secure closure.
Implications:
- This approach offers a viable alternative for managing difficult chest closures in lung transplantation.
- It may reduce complications associated with premature or forced chest closure.
