[Intrathoracic transposition of the musculocutaneous flap in treating empyema]

A 62-year-old woman suffered right empyema caused by methicillin-resistant staphylococcus aureus (MRSA) which occurred following a pancreatico-duodenectomy. After open drainage thoracotomy, intrathoracic transposition of the extended musculocutaneous (MC) flap of the latissimus dorsi was performed. The patient is now in good health, without recurrence of either the empyema or the carcinoma, 19 months after the operation. The MC flap, compared to muscle flap, has the advantages that (1) larger empyema cavities can be obliterated, and (2) the deformity of the thoracic wall can be minimized, because of the small range of resected rib segments and well-preserved volume of subcutaneous tissue in the flap long after transposition.