Management of extensive subcutaneous emphysema using vacuum-assisted closure therapy

Abstract

Subcutaneous emphysema, pneumomediastinum, and pneumopericardium, are a spectrum of disorders, rare in children (1). literature incidence was 0.0025% for spontaneous pneumomediastinum among emergency department visits (2). We present a 7 years old came with a complaining of shortness of breath (SOB) with neck swelling and he was mildly distressed. CT scan showed right pneumothorax, pneumomediastinum, pneumopericardium and extensive subcutaneous emphysema. In the operating room (OR), intercostal chest tubes were inserted bilaterally and bilateral transverse sub-clavicular incisions connected to a vacuum assistant wound closure device (VAC). VAC was found to be effective technique in the management of a massive subcutaneous emphysema. • Subcutaneous emphysema, pneumomediastinum, and pneumopericardium, are a spectrum of disorders, rare in children. • They are group of disorders delineated by abnormal existence of air in the correspondent anatomical location. • Presentation can be widely different, ranging from a mild respiratory symptoms to a life threatening acute respiratory event. • CT scan has been found more sensitive and specific in the diagnosis. • VAC was found to be effective, safe and advisable technique for shortening the management period of a massive subcutaneous emphysema and was to be found safe in pediatric.