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  • An Account of the use of Intrathoracic Flaps in the Management of 12 Consecutive Patients with Residual Cavities following lung surgery

    Ahmed Abdelsalam Hafiz (M.D)*, Youssif Khachaba(M.D)*, Ashraf Elsebaiae Mohammed(M.D)*, Waleed Adel (M.D)**
    *Plastic Surgery Unit of General Surgery Department, Cairo University ** Cardiothoracic Surgery Department, Cairo University

    Introduction: Post-operative patients with empyema and residual cavities, with or without bronchopleural fistulae, represent a collection of desperately ill patients whose clinical conditions have challenged surgeons for years. The techniques to manage these complications include three phases which entail total pleural decortication, obliteration of the empyema cavity, and coverage of the raw parenchymal surface with viable tissue. These, together with proper and effective pleural drainage, have evolved with time and continue to undergo modification. Patient and methods: Twelve patients have been divided into two groups according to the presence or absence of bronchopleural fistula and treated with various intra-thoracic flaps. Results: Results revealed sound healing in ten patients out of twelve. Two patients showed complete failure with persistent bronchopleural fistula and empyema. Conclusion: Intra-thoracic flaps could be used for obliteration of residual postoperative cavities, with or without associated bronchopleural fistulae. In our study, various muscle flaps or omental flap offered enough tissue to obliterate and reinforce healing of vulnerable bronchial stumps after pulmonary resections. Key words: intra-thoracic flaps, empyema, dead space obliteration, bronchopleural fistula.