Open window thoracostomy: a new therapeutic option using topical negative pressure wound therapy

Abstract

Open window thoracostomy (OWT) is an invasive treatment option for thoracic empyema that is seldom indicated. These wounds are accompanied with a prolonged hospital stay and significant patient discomfort over an extended period of time. A retrospective report was conducted on patients who underwent OWT at the Academic Medical Center (Amsterdam, The Netherlands) and evaluated if topical negative pressure therapy ([TNP], V.A.C.® Therapy™, KCI Medical BV, Houten, The Netherlands) is a valid treatment option for these wounds. Clinical outcome and applied management methods are analyzed. Between January 1986 and June 2005, 15 patients, with a mean age of 54 years, were treated with OWT. Recently, the authors have used TNP in combination with OWT as a new treatment modality to obtain rapid control over pleural bacterial load and to achieve a well-vascularized wound surface. Good clinical results and a trend toward shorter hospital stays and improved quality of life were seen. Open window thoracostomy as a treatment modality for thoracic empyema is a valid option but only when other means fail or are contraindicated. Treatment of open window thoracostomy in combination with TNP is a safe and adequate therapeutic option for thoracic empyema resulting in improved quality of life and overall shorter hospital sta