Subcutaneous emphysema surgery: Difference between revisions
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==Overview== | ==Overview== | ||
Although the underlying conditions require treatment, subcutaneous emphysema usually does not; small amounts of air are reabsorbed by the body. However, subcutaneous emphysema can be uncomfortable and may interfere with breathing, and is often treated by removing air from the tissues, for example by using a chest tube. | |||
==Surgery== | ==Surgery== | ||
Subcutaneous emphysema is usually [[benign]].<ref name="pleural"> | Subcutaneous emphysema is usually [[benign]].<ref name="pleural"> | ||
{{ | {{cite book |editor=Bouros D |title=Pleural Disease (Lung Biology in Health and Disease) |publisher=Marcel Dekker |location=New York, N.Y |year=2004 |isbn=0-8247-4027-0 |oclc= |doi= |accessdate= 2008-05-16 |chapter=Pleural disease in the intensive care unit |author=Papiris SA, Roussos C |pages=771–777|url= http://books.google.com/books?id=PS8j3r31vWwC&pg=PA771&dq=subcutaneous+emphysema&lr=&client=firefox-a&sig=V8fQvguiH5tb-2xS6Sf8UnQGiGQ }} | ||
cite book |editor=Bouros D |title=Pleural Disease (Lung Biology in Health and Disease) |publisher=Marcel Dekker |location=New York, N.Y |year=2004 |isbn=0-8247-4027-0 |oclc= |doi= |accessdate= 2008-05-16 |chapter=Pleural disease in the intensive care unit |author=Papiris SA, Roussos C |pages=771–777|url= http://books.google.com/books?id=PS8j3r31vWwC&pg=PA771&dq=subcutaneous+emphysema&lr=&client=firefox-a&sig=V8fQvguiH5tb-2xS6Sf8UnQGiGQ }} | |||
</ref> Most of the time, SCE itself does not need treatment (though the conditions from which it results may); however, if the amount of air is large, it can interfere with breathing and be uncomfortable.<ref name="Abu-Omar95"> | </ref> Most of the time, SCE itself does not need treatment (though the conditions from which it results may); however, if the amount of air is large, it can interfere with breathing and be uncomfortable.<ref name="Abu-Omar95"> | ||
{{ | {{ | ||
cite journal |author=Abu-Omar Y, Catarino PA |title=Progressive subcutaneous emphysema and respiratory arrest |journal=J R Soc Med |volume=95 |issue=2 |pages=90–91 |year=2002 |month=February |pmid=11823553 |doi= |url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1279319 | cite journal |author=Abu-Omar Y, Catarino PA |title=Progressive subcutaneous emphysema and respiratory arrest |journal=J R Soc Med |volume=95 |issue=2 |pages=90–91 |year=2002 |month=February |pmid=11823553 |doi= |url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1279319 | ||
}} | }} | ||
</ref> Severe cases can compress the trachea and do require treatment.<ref name="Carpenito04"> | </ref> Severe cases can compress the [[trachea]], and they do require treatment.<ref name="Carpenito04"> | ||
{{ | {{ | ||
cite book |author=Carpenito-Moyet LJ |title=Nursing Care Plans and Documentation: Nursing Diagnoses and Collaborative Problems |publisher=Lippincott Williams & Wilkins |location=Hagerstown, MD |year=2004 |pages= 889 |isbn=0-7817-3906-3 |oclc= |doi= |accessdate= 2008-05-12 |url=http://books.google.com/books?id=Qyz8W5qS1dQC&pg=PA889&dq=subcutaneous+emphysema&lr=&client=firefox-a&sig=6d6W5YvFmUyN3z0Gch066nWoxQY#PPA889,M1 | cite book |author=Carpenito-Moyet LJ |title=Nursing Care Plans and Documentation: Nursing Diagnoses and Collaborative Problems |publisher=Lippincott Williams & Wilkins |location=Hagerstown, MD |year=2004 |pages= 889 |isbn=0-7817-3906-3 |oclc= |doi= |accessdate= 2008-05-12 |url=http://books.google.com/books?id=Qyz8W5qS1dQC&pg=PA889&dq=subcutaneous+emphysema&lr=&client=firefox-a&sig=6d6W5YvFmUyN3z0Gch066nWoxQY#PPA889,M1 | ||
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</ref> Suction may also be applied to the tube to remove air faster.<ref name="Long95"/> The progression of the condition can be monitored by marking the boundaries with a special pencil for marking on skin.<ref name="Carpenito04"/> | </ref> Suction may also be applied to the tube to remove air faster.<ref name="Long95"/> The progression of the condition can be monitored by marking the boundaries with a special pencil for marking on skin.<ref name="Carpenito04"/> | ||
Since treatment usually involves dealing with the underlying condition, cases of spontaneous subcutaneous emphysema may require nothing more than bed rest, medication to control pain, and perhaps supplemental oxygen.<ref name="Parker90"/> Breathing oxygen may help the body to absorb the subcutaneous air more quickly.<ref name="NOAA91"> | Since treatment usually involves dealing with the underlying condition, cases of spontaneous subcutaneous emphysema may require nothing more than bed rest, medication to control pain, and perhaps supplemental oxygen.<ref name="Parker90"> | ||
{{ | |||
cite journal |author=Parker GS, Mosborg DA, Foley RW, Stiernberg CM |title=Spontaneous cervical and mediastinal emphysema |journal=Laryngoscope |volume=100 |issue=9 |pages=938–940 |year=1990 |month=September |pmid=2395401 |doi= |url= | |||
}} | |||
</ref> Breathing oxygen may help the body to absorb the subcutaneous air more quickly.<ref name="NOAA91"> | |||
{{ | {{ | ||
cite book |author=NOAA|title=NOAA Diving Manual |publisher=US Dept. of Commerce – National Oceanic and Atmospheric Administration |location= |year=1991 |isbn=0160359392 |oclc= |doi= |accessdate= 2008-05-09| pages=3.15 |url=http://books.google.com/books?id=MV55XeyatnwC&pg=PT47&dq=subcutaneous+emphysema&sig=nhUBUEP7DJTri6j1WqVE3jkTY2Y | cite book |author=NOAA|title=NOAA Diving Manual |publisher=US Dept. of Commerce – National Oceanic and Atmospheric Administration |location= |year=1991 |isbn=0160359392 |oclc= |doi= |accessdate= 2008-05-09| pages=3.15 |url=http://books.google.com/books?id=MV55XeyatnwC&pg=PT47&dq=subcutaneous+emphysema&sig=nhUBUEP7DJTri6j1WqVE3jkTY2Y | ||
}} | }} | ||
</ref> Reassurance and observation are also part of treatment.<ref name="Jain08"/> | </ref> Reassurance and observation are also part of treatment.<ref name="Jain08"> | ||
{{ | |||
cite journal |author=Jain P, Vanner T |title=Subcutaneous emphysema with pneumomediastinum during the second stage of labour: A rare intrapartum complication |journal=The Internet Journal of Gynecology and Obstetrics |volume=9 |issue=1 |pages= |year=2008 |pmid= |doi= |url=http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijgo/vol9n1/emphysema.xml | |||
}} | |||
</ref> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Chest trauma]] | [[Category:Chest trauma]] | ||
[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Physical examination]] | |||
{{WH}} | |||
{{WS}} | |||
Latest revision as of 16:14, 15 June 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Although the underlying conditions require treatment, subcutaneous emphysema usually does not; small amounts of air are reabsorbed by the body. However, subcutaneous emphysema can be uncomfortable and may interfere with breathing, and is often treated by removing air from the tissues, for example by using a chest tube.
Surgery
Subcutaneous emphysema is usually benign.[1] Most of the time, SCE itself does not need treatment (though the conditions from which it results may); however, if the amount of air is large, it can interfere with breathing and be uncomfortable.[2] Severe cases can compress the trachea, and they do require treatment.[3]
In severe cases of subcutaneous emphysema, catheters can be placed in the subcutaneous tissue to release the air.[1] Small cuts, or "blow holes", may be made in the skin to release the gas.[4] When subcutaneous emphysema occurs due to pneumothorax, a chest tube is frequently used to control the latter; this eliminates the source of the air entering the subcutaneous space.[5] If the volume of subcutaneous air is increasing, it may be that the chest tube is not removing air rapidly enough, so it may be replaced with a larger one.[6] Suction may also be applied to the tube to remove air faster.[6] The progression of the condition can be monitored by marking the boundaries with a special pencil for marking on skin.[3]
Since treatment usually involves dealing with the underlying condition, cases of spontaneous subcutaneous emphysema may require nothing more than bed rest, medication to control pain, and perhaps supplemental oxygen.[7] Breathing oxygen may help the body to absorb the subcutaneous air more quickly.[8] Reassurance and observation are also part of treatment.[9]
References
- ↑ 1.0 1.1 Papiris SA, Roussos C (2004). "Pleural disease in the intensive care unit". In Bouros D. Pleural Disease (Lung Biology in Health and Disease). New York, N.Y: Marcel Dekker. pp. 771–777. ISBN 0-8247-4027-0. Retrieved 2008-05-16.
- ↑
Abu-Omar Y, Catarino PA (2002). "Progressive subcutaneous emphysema and respiratory arrest". J R Soc Med. 95 (2): 90–91. PMID 11823553. Unknown parameter
|month=ignored (help) - ↑ 3.0 3.1 Carpenito-Moyet LJ (2004). Nursing Care Plans and Documentation: Nursing Diagnoses and Collaborative Problems. Hagerstown, MD: Lippincott Williams & Wilkins. p. 889. ISBN 0-7817-3906-3. Retrieved 2008-05-12.
- ↑ Grathwohl KW, Miller S (2004). "Anesthetic implications of minimally invasive urological surgery". In Bonnett R, Moore RG, Bishoff JT, Loenig S, Docimo SG. Minimally Invasive Urological Surgery. London: Taylor & Francis Group. p. 105. ISBN 1-84184-170-6. Retrieved 2008-05-11.
- ↑ Lefor, Alan T. (2002). Critical Care on Call. New York: Lange Medical Books/McGraw-Hill, Medical Publishing Division. pp. 238–240. ISBN 0-07-137345-4. Retrieved 2008-05-09.
- ↑ 6.0 6.1 Long BC Cassmeyer V, Phipps WJ (1995). Adult Nursing: Nursing Process Approach. St. Louis: Mosby. p. 328. ISBN 0-7234-2004-1. Retrieved 2008-05-12.
- ↑
Parker GS, Mosborg DA, Foley RW, Stiernberg CM (1990). "Spontaneous cervical and mediastinal emphysema". Laryngoscope. 100 (9): 938–940. PMID 2395401. Unknown parameter
|month=ignored (help) - ↑ NOAA (1991). NOAA Diving Manual. US Dept. of Commerce – National Oceanic and Atmospheric Administration. p. 3.15. ISBN 0160359392. Retrieved 2008-05-09.
- ↑ Jain P, Vanner T (2008). "Subcutaneous emphysema with pneumomediastinum during the second stage of labour: A rare intrapartum complication". The Internet Journal of Gynecology and Obstetrics. 9 (1).