Temporary Extrathoracic Vacuum Therapy Splint in Chest Wall Reconstruction

Area of Science:

• Thoracic Surgery
• Wound Management
• Mechanical Ventilation

Background:

• Paradoxical respiration is a complication of chest cage defects, persisting post-reconstruction.
• This condition prolongs mechanical ventilation dependency and delays patient recovery.
• Chest wall reconstruction aims to correct defects but may not fully resolve respiratory mechanics issues.

Observation:

• Negative pressure wound therapy (NPWT) was applied postoperatively to a chest wall defect reconstructed with mesh and flap.
• The therapy aimed to stabilize the reconstructed area and improve respiratory function.
• Key parameters including arterial blood gas (ABG), oxygenation, and ventilation pressures were monitored.

Findings:

• Application of NPWT over the reconstructed chest wall led to significant improvements in breathing mechanics.
• Positive changes were observed in arterial blood gas (ABG) values, oxygen saturation (SpO2), and ventilator settings (FiO2, PEEP).
• Hemodynamic stability was maintained throughout the NPWT application period.

Implications:

• Negative extrathoracic pressure via NPWT can act as a temporary splint for reconstructed chest walls.
• This intervention facilitates earlier discontinuation of mechanical ventilation.
• NPWT promotes a smoother and potentially faster postoperative recovery in patients with complex chest wall defects.