A Novel Therapeutic Approach Using the Combination of Vacuum-assisted Closure System and 1-Way Valve After Open-Window Thoracostomy in Treating Chronic Empyema Complicated by Multiple Bronchopleural Fistulae

Supplemental Digital Content is available in the text. Empyema thoracis may be an ancient disease, but it still occurs in present-day thoracic practice. Despite medical and technical progression, pleural infection remains a major health care concern. When empyema thoracis is complicated by bronchopleural fistulae or repeated infections, it becomes a clinical challenge to physicians and can substantially lengthen and complicate a patient’s course of treatment. This case report presents a 48-year-old male patient with chronic empyema and multiple bronchopleural fistulae who was effectively treated by a combination of a 1-way valve and vacuum-assisted closure system through open-window thoracostomy. This combination successfully prevented air accumulation beneath the wound dressing, and therefore it was possible to maintain negative pressure, which is essential for the vacuum-assisted closure system to function.