Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
LungHY (1), Pang YK(1)
Affiliation :
(1) Stoma and Wound Clinic, Queen Elizabeth Hospital
(2) Department of Surgery, Queen Elizabeth Hospital
Introduction :
Subcutaneous emphysema (SE) occurs when air leaks into soft tissue, often causing respiratory distress. While most cases are benign and resolve on their own, severe cases can lead to respiratory distress, requiring intervention. Negative Pressure Wound Therapy (NPWT) offers an alternative to traditional techniques like thoracotomy, which is beneficial for patients where invasive procedures increase risks.
Objectives :
The objective is to present a case where a NPWT is successfully used to manage extensive SE, leading to a more cosmetically pleasing result and stable thoracic injury without avoiding the need for more invasive procedures and associated risk. It demonstrates the effectiveness and safety of NPWT as a minimally invasive technique for managing extensive SE.
Methodology :
An 82-year-old male underwent video-assisted thoracic esophagectomy for cancer of 0esophagus then postoperative developed extensive bilateral SE, both upper & lower limbs and trunk, leading to respiratory distress. He received a bedside incision for air release. Referred from the surgeon and started NPWT at -80mmHg in first week, later increased the pressure to -100mmHg. Serial chest X-rays and clinical examination confirmed the resolution of extensive SE.
Result & Outcome :
NPWT facilitated the removal of trapped air and showed a decrease in subcutaneous air, as evidenced radiographically and clinically. After one week, a significant decrease of SE in lower limbs is observed. Vital sign stable and SaO2 98% on O2 1L/min. Compared to traditional surgical approaches like thoracotomy, the minimally invasive NPWT technique reduced risks of bleeding, pain, and surgical site infections. This case highlights NPWT as a safe and effective strategy for resolving extensive SE. Delivering therapy at the bedside is a significant advantage of this technique for reducing patient risks.
