[Negative Pressure Wound Therapy as a Treatment Option for Extensive Post-Trauma Subcutaneous Emphysema].

Area of Science:

• Pulmonology
• Thoracic Surgery
• Critical Care Medicine

Background:

• Subcutaneous emphysema is a potential complication of chest trauma or advanced chronic obstructive pulmonary disease (COPD) with ruptured bullae.
• Massive subcutaneous emphysema can significantly impair respiratory mechanics and venous return, potentially leading to respiratory insufficiency and the need for mechanical ventilation.

Observation:

• A case study involving a 77-year-old male patient with significant comorbidities presented with extensive subcutaneous emphysema following blunt chest wall trauma.
• The patient developed respiratory insufficiency, and conventional treatment with a chest drain proved ineffective.

Findings:

• Subfascial negative pressure therapy applied infraclavicularly to the pectoral muscle area resulted in rapid subsidence of subcutaneous emphysema.
• The negative pressure therapy substantially improved the patient's overall clinical condition.

Implications:

• Local negative pressure therapy presents a viable alternative for managing massive subcutaneous emphysema, particularly when standard chest drain treatment fails.
• This therapeutic approach is suitable for patients with expanded pleural cavities and those at high surgical risk, offering a less invasive option.