陰圧閉鎖療法が有効であった有瘻性膿胸の1例

Effective Treatment for Empyema with Fistula by Negative Pressure Wound Therapy：Report of a Case

はじめに　有瘻性膿胸に対する無瘻化の方法は多岐にわたる．われわれは，有瘻性膿胸に対して一期的な広背筋弁による瘻孔閉鎖と開窓術に陰圧閉鎖療法（negative pressure wound therapy：NPWT）を施行し有効であった1例を経験したので報告する．

A 54-year-old male with alcoholic cirrhosis and diabetes mellitus was referred to our hospital for the treatment of right pleural empyema with fistula. Despite performing a simple suture closure of the pulmonary fistula, air leakage occurred one week after surgery. Hence, we covered the fistula with a pediculed muscle flap associated with an open window thoracostomy. After 32 days of gauze drainage, negative pressure wound therapy （NPWT） was introduced for reducing the residual pleural space. A chest computed tomography （CT） scan showed almost the full expansion of the lung after undergoing 98 days of NPWT. The patient was discharged from the hospital four months after thoracostomy.