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The Annals of Thoracic Surgery, Vol 40, 396-397, Copyright © 1985 by The Society of Thoracic Surgeons

ARTICLES

Clostridial myonecrosis of the chest wall complicating spontaneous esophageal rupture

J LoCicero 3d and RM Vanecko

Spontaneous rupture of the esophagus (Boerhaave's syndrome) has a dismal survival rate without prompt surgical management. A variety of surgical regimens have achieved survival of 70% or greater; however, the postoperative course is frequently complicated by fistula, would infection, empyema, and sepsis. We report an unusual postoperative chest wound infection of clostridial myonecrosis, which presumably originated from the patient's gastric microflora. He was treated with immediate surgical debridement of all involved tissue, prolonged ventilation, total parenteral nutrition, and frequent dressing changes. The remaining defect was closed with a skin graft. Anaerobic wound infections of the chest wall and their management are discussed.

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