# A Case of Tension Subcutaneous Emphysema Treated With Minimally Invasive Open-Window Thoracostomy Using a Wound Protector/Retractor and Three-Sided Taping

## TL;DR

A patient with life-threatening tension subcutaneous emphysema was successfully treated using a minimally invasive surgical technique.

## Contribution

A novel minimally invasive approach using a wound protector and three-sided taping to manage tension subcutaneous emphysema is presented.

## Key findings

- The technique prevented air from entering the subcutaneous space while draining trapped air.
- This approach avoided creating an open pneumothorax during treatment.
- It offers a viable emergency option for managing air leakage in such cases.

## Abstract

Subcutaneous emphysema is a common complication of thoracic surgery. Tension subcutaneous emphysema that causes airway obstruction is rare but life-threatening. This report presents a patient who developed tension subcutaneous emphysema after recurrent secondary pneumothorax surgery which was treated with minimally invasive open-window thoracostomy. A wound protector/retractor and three-sided taping were successfully used to prevent air from entering the subcutaneous space via the wound while draining trapped air without creating an open pneumothorax. This approach is an option for managing subcutaneous and intrathoracic air leakage in emergency situations.