PLASTY OF A LARGE THROUGH THORACIC WALL DEFECT WITH THE HELP OF VRAM-FLAP: A CLINICAL CASE
At present, there is a fairly large number of surgical interventions, both open and video-assisted thoracoscopic, on the chest organs in oncopathology and pulmonary tuberculosis, as well as in various pyoinflammatory and nonspecific diseases of the lungs and pleura. However, a consequence of the inc...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Scientia Publishing House
2022-10-01
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| Series: | Juvenis Scientia |
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| Online Access: | https://jscientia.org/index.php/js/user/setLocale/en_US?source=/index.php/js/article/view/164?utm_source=DOAJ |
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| author | V. G. Zolotykh E. A. Kaylanych M. S. Shalaev A. O. Petrachkov A. O. Avetisyan P. K. Yablonsky A. I. Dubko K. Yu. Medvedeva A. E. Tusenko |
| author_facet | V. G. Zolotykh E. A. Kaylanych M. S. Shalaev A. O. Petrachkov A. O. Avetisyan P. K. Yablonsky A. I. Dubko K. Yu. Medvedeva A. E. Tusenko |
| author_sort | V. G. Zolotykh |
| collection | DOAJ |
| description | At present, there is a fairly large number of surgical interventions, both open and video-assisted thoracoscopic, on the chest organs in oncopathology and pulmonary tuberculosis, as well as in various pyoinflammatory and nonspecific diseases of the lungs and pleura. However, a consequence of the increase in surgical activity is an increase in the number of postoperative complications, the most severe of which are bronchopleural complications. The management of patients with inadequate sealing after lung resection is one of the most common problems in thoracic surgery. Thoracostomy is still actively used in patients with a long-term residual pleural cavity with a volume of more than 1 / 3 of the hemithorax, with the ineffectiveness of the measures taken to achieve aerostasis (change of active and passive aspiration, pneumoperitoneum, chemical pleurodesis), in the absence of the effect of closed drainage, videothoracoscopy, and with the further development of empyema. Thus, surgical treatment of lung pathology on the background of local infectious process and delayed lung expansion on the background of COPD is largely associated with the risk of complications. One of them is the empyema of the pleura, which, in this clinical case, was complicated by severe osteomyelitis of the ribs, requiring several thoracoplasties with the appearance of large thoracostomy. One of the methods for treatment of such defects is flap plastics. In the presented clinical case, thoracostomy surgery of the right hemitorax was performed with a vertical flap on the rectus abdominis (VRAM-flap). |
| first_indexed | 2024-04-10T15:32:45Z |
| format | Article |
| id | doaj.art-d0833034d3514db1bdffaeb97e7c894c |
| institution | Directory Open Access Journal |
| issn | 2414-3782 2414-3790 |
| language | English |
| last_indexed | 2024-04-10T15:32:45Z |
| publishDate | 2022-10-01 |
| publisher | Scientia Publishing House |
| record_format | Article |
| series | Juvenis Scientia |
| spelling | doaj.art-d0833034d3514db1bdffaeb97e7c894c2023-02-13T11:22:18ZengScientia Publishing HouseJuvenis Scientia2414-37822414-37902022-10-0185384610.32415/jscientia_2022_8_5_38-46PLASTY OF A LARGE THROUGH THORACIC WALL DEFECT WITH THE HELP OF VRAM-FLAP: A CLINICAL CASEV. G. Zolotykh0https://orcid.org/0000-0001-8671-6197E. A. Kaylanych1https://orcid.org/0000-0003-4200-0407M. S. Shalaev2https://orcid.org/0000-0003-4015-8403A. O. Petrachkov3https://orcid.org/0000-0003-3363-3843A. O. Avetisyan4https://orcid.org/0000-0003-4590-2908P. K. Yablonsky5https://orcid.org/0000-0003-4385-9643A. I. Dubko6https://orcid.org/0000-0002-4171-5411K. Yu. Medvedeva7https://orcid.org/0000-0001-7322-5807A. E. Tusenko8https://orcid.org/0000-0003-0689-6058City Hospital No. 40 Kurortny districtOryol Regional Clinical HospitalOryol Regional Clinical HospitalSt Petersburg University’s N.I. Pirogov Clinic of High Medical TechnologiesSaint-Petersburg Research Institute of PhthisiopulmonologySaint-Petersburg Research Institute of Phthisiopulmonology; Saint Petersburg State UniversitySt Petersburg University’s N.I. Pirogov Clinic of High Medical TechnologiesSaint Petersburg Institute of Emergency Care n.a. I.I. DzhanelidzeSaint Petersburg State Pediatric Medical UniversityAt present, there is a fairly large number of surgical interventions, both open and video-assisted thoracoscopic, on the chest organs in oncopathology and pulmonary tuberculosis, as well as in various pyoinflammatory and nonspecific diseases of the lungs and pleura. However, a consequence of the increase in surgical activity is an increase in the number of postoperative complications, the most severe of which are bronchopleural complications. The management of patients with inadequate sealing after lung resection is one of the most common problems in thoracic surgery. Thoracostomy is still actively used in patients with a long-term residual pleural cavity with a volume of more than 1 / 3 of the hemithorax, with the ineffectiveness of the measures taken to achieve aerostasis (change of active and passive aspiration, pneumoperitoneum, chemical pleurodesis), in the absence of the effect of closed drainage, videothoracoscopy, and with the further development of empyema. Thus, surgical treatment of lung pathology on the background of local infectious process and delayed lung expansion on the background of COPD is largely associated with the risk of complications. One of them is the empyema of the pleura, which, in this clinical case, was complicated by severe osteomyelitis of the ribs, requiring several thoracoplasties with the appearance of large thoracostomy. One of the methods for treatment of such defects is flap plastics. In the presented clinical case, thoracostomy surgery of the right hemitorax was performed with a vertical flap on the rectus abdominis (VRAM-flap).https://jscientia.org/index.php/js/user/setLocale/en_US?source=/index.php/js/article/view/164?utm_source=DOAJ pleural empyemathoracoplastythoracostomyplastic surgeryvram-flap |
| spellingShingle | V. G. Zolotykh E. A. Kaylanych M. S. Shalaev A. O. Petrachkov A. O. Avetisyan P. K. Yablonsky A. I. Dubko K. Yu. Medvedeva A. E. Tusenko PLASTY OF A LARGE THROUGH THORACIC WALL DEFECT WITH THE HELP OF VRAM-FLAP: A CLINICAL CASE Juvenis Scientia pleural empyema thoracoplasty thoracostomy plastic surgery vram-flap |
| title | PLASTY OF A LARGE THROUGH THORACIC WALL DEFECT WITH THE HELP OF VRAM-FLAP: A CLINICAL CASE |
| title_full | PLASTY OF A LARGE THROUGH THORACIC WALL DEFECT WITH THE HELP OF VRAM-FLAP: A CLINICAL CASE |
| title_fullStr | PLASTY OF A LARGE THROUGH THORACIC WALL DEFECT WITH THE HELP OF VRAM-FLAP: A CLINICAL CASE |
| title_full_unstemmed | PLASTY OF A LARGE THROUGH THORACIC WALL DEFECT WITH THE HELP OF VRAM-FLAP: A CLINICAL CASE |
| title_short | PLASTY OF A LARGE THROUGH THORACIC WALL DEFECT WITH THE HELP OF VRAM-FLAP: A CLINICAL CASE |
| title_sort | plasty of a large through thoracic wall defect with the help of vram flap a clinical case |
| topic | pleural empyema thoracoplasty thoracostomy plastic surgery vram-flap |
| url | https://jscientia.org/index.php/js/user/setLocale/en_US?source=/index.php/js/article/view/164?utm_source=DOAJ |
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