Negative Pressure Wound Therapy for Residual Cavity Reduction After Open-Window Thoracostomy Following Pneumonectomy.

Postpneumonectomy empyema with a bronchopleural fistula (BPF) usually requires open-window thoracostomy, which can leave a large difficult-to-close residual cavity when muscle or omental flaps are unavailable. An 81-year-old man who developed empyema with a BPF after completion left pneumonectomy underwent open-window thoracostomy. The BPF closed with granulation, and the large pleural cavity remained. Negative-pressure wound therapy (-50 to -75 mm Hg) achieved >50% cavity reduction within 10 days, enabling definitive thoracoplasty. Negative-pressure wound therapy appears a safe and effective option for reducing postpneumonectomy cavities and facilitating chest closure when conventional filling procedures are not feasible.