Management of extensive surgical emphysema with subcutaneous drain and incisional negative pressure wound therapy

This report details a man in his late 60s who presented with a new right-sided pneumothorax against the background of advanced COPD and a known large apical bulla. Multiple chest drains were inserted to manage the pneumothorax but the patient developed extensive surgical emphysema causing significant distress. Reported here is the management of the extensive surgical emphysema and techniques used to insert a subcutaneous drain and incisional negative pressure wound therapy, ultimately with positive results. This report will briefly explore other techniques to manage subcutaneous emphysema, with the focus then on how negative pressure wound therapy can be implemented and benefit patients who are too frail/comorbid for further invasive interventions.