Eloesser flap

Eloesser-flap

Eloesser flap

The Eloesser flap is a surgical procedure used primarily in the management of chronic empyema, a condition characterized by the accumulation of pus in the pleural cavity. This technique was first described by the American surgeon Leo Eloesser in 1935.

Indications

The Eloesser flap is indicated in patients with chronic empyema who have not responded to conventional treatments such as antibiotics and chest tube drainage. It is particularly useful in cases where the pleural space needs to be drained continuously to prevent the re-accumulation of infected fluid.

Procedure

The procedure involves creating a permanent opening in the chest wall to allow continuous drainage of the pleural cavity. The steps are as follows:

1. A U-shaped incision is made in the chest wall, typically in the fifth or sixth intercostal space.
2. A flap of skin and subcutaneous tissue is created and turned inward to form a stoma.
3. The underlying rib is resected to create an opening into the pleural cavity.
4. The flap is sutured to the pleura to maintain the opening and allow for continuous drainage.

Postoperative Care

Postoperative care involves regular dressing changes and monitoring for signs of infection. The stoma created by the Eloesser flap allows for the insertion of a catheter or drainage tube to facilitate continuous drainage. Patients may require long-term follow-up to manage the stoma and ensure effective drainage.

Complications

Complications of the Eloesser flap can include:

• Infection
• Bleeding
• Displacement of the flap
• Chronic pain at the site of the stoma

History

The Eloesser flap was developed by Leo Eloesser, a pioneering thoracic surgeon, in the early 20th century. His work significantly advanced the treatment of chronic empyema and other pleural diseases.

Related Procedures

• Thoracostomy
• Decortication (surgery)
• Pleurodesis

See Also

• Empyema
• Pleural cavity
• Thoracic surgery
• Leo Eloesser