Abstract
Background Paradoxical respiration is a sinister consequence of bony chest cage defects which
can persist even post chest wall reconstruction. It leads to prolonged dependence
on mechanical ventilation postoperatively, thereby delaying recovery. Methods Negative pressure wound therapy (NPWT) was applied in early postoperative period
to a patient with chest wall defect reconstructed with folded prolene mesh and free
anterolateral thigh flap. Arterial blood gas (ABG), fraction of inspired oxygen (FiO2), peak end expiratory pressure (PEEP), oxygen saturation (SpO2), and blood pressure (BP) readings pre and post NPWT application were compared. Results There was marked improvement in the breathing mechanics and related parameters post
NPWT application over the flap. Conclusions Negative extrathoracic pressure in the form of a temporary splint can enable early
weaning off the ventilator and a smoother postoperative recovery in reconstructed
chest wall defects.
Keywords
chest wall reconstruction - negative pressure wound therapy - paradoxical respiration
