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Korean Journal of Thoracic and Cardiovascular Surgery

Published online December 9, 2020

Copyright © Journal of Chest Surgery.

Massive Necrotizing Fasciitis of the Chest Wall: A Very Rare Case Report of a Closed Thoracostomy Complication

Sangwook Chun M.D. , Gyeongho Lee M.D. , Kyoung Min Ryu M.D., Ph.D.

Department of Thoracic and Cardiovascular Surgery, Dankook University Hospital, Cheonan, Korea

Correspondence to:Kyoung Min Ryu
Tel 82-41-550-7640
Fax 82-41-550-7060
E-mail cskmin@naver.com
ORCID
https://orcid.org/0000-0001-8461-6010

Received: September 25, 2020; Revised: October 18, 2020; Accepted: October 20, 2020

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properlycited.

Abstract

We present a case study of necrotizing fasciitis (NF), a very rare but dangerous complication of chest tube management. A 69-year-old man with shortness of breath underwent thoracostomy for chest tube placement and drainage with antibiotic treatment, followed by a computed tomography scan. He was diagnosed with thoracic empyema. Initially, a non-cardiovascular and thoracic surgeon managed the drainage, but the management was inappropriate. The patient developed NF at the tube site on the chest wall, requiring emergency fasciotomy and extensive surgical debridement. He was discharged without any complications after successful control of NF. A thoracic surgeon can perform both tube thoracostomy and tube management directly to avoid complications, as delayed drainage might result in severe complications.

Keywords: Empyema, Chest tubes, Necrotizing fasciitis

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Korean Journal of Thoracic and Cardiovascular Surgery

Published online December 9, 2020

Copyright © Journal of Chest Surgery.

Massive Necrotizing Fasciitis of the Chest Wall: A Very Rare Case Report of a Closed Thoracostomy Complication

Sangwook Chun M.D. , Gyeongho Lee M.D. , Kyoung Min Ryu M.D., Ph.D.

Department of Thoracic and Cardiovascular Surgery, Dankook University Hospital, Cheonan, Korea

Correspondence to:Kyoung Min Ryu
Tel 82-41-550-7640
Fax 82-41-550-7060
E-mail cskmin@naver.com
ORCID
https://orcid.org/0000-0001-8461-6010

Received: September 25, 2020; Revised: October 18, 2020; Accepted: October 20, 2020

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properlycited.

Abstract

We present a case study of necrotizing fasciitis (NF), a very rare but dangerous complication of chest tube management. A 69-year-old man with shortness of breath underwent thoracostomy for chest tube placement and drainage with antibiotic treatment, followed by a computed tomography scan. He was diagnosed with thoracic empyema. Initially, a non-cardiovascular and thoracic surgeon managed the drainage, but the management was inappropriate. The patient developed NF at the tube site on the chest wall, requiring emergency fasciotomy and extensive surgical debridement. He was discharged without any complications after successful control of NF. A thoracic surgeon can perform both tube thoracostomy and tube management directly to avoid complications, as delayed drainage might result in severe complications.

Keywords: Empyema, Chest tubes, Necrotizing fasciitis

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