TY - JOUR T1 - Complex surgical solution for thoracic wall necrotizing fasciitis JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P2414 AU - Cornel Petreanu AU - Leonard Militaru AU - Boris Constantin Coman AU - Elisabeta Balaita AU - Nicolae Galie Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P2414.abstract N2 - Necrotizing fasciitis of thoracic wall is a severe disease which is associated with a high rate of mortality, especially for imunosupressed patients. Multiple drainage incisions, excision of necrotic tissues and apropiate antibiotherapy represent the right therapeutic solution.The authors present the case of 43 years old male, diagnosed with left empyema secondary to pulmonary tuberculosis. A left tube thoracothomy was performed for drainage, followed by surgical emphysema (secondary to increase air leaks) and necrotizing fasciitis surrounding the tube thoracotomy, which has extended to left hypochondrium. First, multiple drainage incisions were performed, with excision of necrotic tissues and antibiotherapy.Azorin's procedure was performed after, closing the main left bronchus and the air leaks were stopped.After 18 days, the thoracic wall wounds were healed, allowing left pneumonectomy to be performed. Sputum exam became negative soon after closing the left main bronchus.Closing the left main bronchus using the Azorin's procedure stopped the air leaks, which led to decreased of microbial contamination of the thoracic wall wounds and good out-come. ER -