Management of Subcutaneous Emphysema After Pulmonary Resection

Subcutaneous emphysema is more likely in patients who have an FEV1% less than 50% and who undergo a redo thoracotomy. Recalcitrant SE emphysema (SE that persists despite increasing chest tube suction) is more likely in patients who undergo lobectomy and is best treated by video-assisted thorascopic surgery with pneumolysis between the leaking lung, which is usually partially adhered to the previously opened intercostal space. This directs the air leak back into the pleural space and out of the subcutaneous space. This procedure shortens the duration of SE and hospital stay.