J Reconstr Microsurg 2009; 25(3): 213-218
DOI: 10.1055/s-0028-1104549
© Thieme Medical Publishers

Tissue Plug Technique for Management of Large Chronic Empyema Defects and Bronchopleural Fistulas

Hung-Chi Chen1 , Sukru Yazar1 , Ali Engin Ulusal1 , Yi-Tien Liu2 , Christopher J. Salgado1
  • 1Department of Plastic & Reconstructive Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taipei
  • 2Department of Plastic & Reconstructive Surgery, I-Shou Hospital, I-Shou University, Kaohsiung, Taiwan, Republic of China
Further Information

Publication History

Publication Date:
02 January 2009 (online)


After multiple thoracotomies, local muscles are often transected or sacrificed for the treatment of intrathoracic infection. In these conditions, free tissue transfers are described as an alternative. Five anterolateral thigh musculocutaneous free flaps were used for the treatment of complicated large chronic empyema defects and bronchopleural fistulas with a special flap inset and gauze-packing method, the so-called tissue plug technique. All flaps survived completely without complication. There was no sign of recurrent infection, and the bronchopleural fistulas were sealed and the empyema cavities completely obliterated. We concluded that the tissue plug technique is an alternative for the management of difficult empyema cavities and bronchopleural fistulas in selected patients where the soft tissue flap is not enough to fill the complete dead spaces.


Sukru Yazar, M.D. 

Sancaktar Tekkesi Sok., Fen Apt. No: 37/29

34310 Kocamustafapasa, Istanbul, Turkey

Email: sukruyazar@hotmail.com