Simultaneous Combination Therapy of Free Anterolateral Thigh Flap and Negative-pressure Wound Therapy With Penrose Drains for Thoracic Dead Space

Open-window thoracostomy is an effective treatment for refractory postpneumonectomy empyema. However, it can leave large thoracic dead space, and bronchopleural fistulas (BPF) are a common major complication. These problems can be treated with myocutaneous flap transfer or negative-pressure wound therapy (NPWT). However, treatment is often difficult and prolonged. Here, we report 2 cases of free anterolateral thigh flap transfer followed immediately by NPWT combined with Penrose drains. Both patients, including 1 with BPF, had favorable postoperative courses and were discharged 28 and 14 days after reconstruction. Dead space infection and BPF recurrence were not observed after discharge. Following free flap transfer with NPWT combined with Penrose drains may efficiently eliminate dead space and accelerate wound healing in a large three-dimensional space.