A study of subcutaneous emphysema, factors contributing to its development, resolution and management with different modalities

Abstract

Subcutaneous emphysema is defined as an escape of air in subcutaneous tissue. It is one of the most common complications after inter-costal chest tube drainage. Subcutaneous emphysema is usually benign requiring no specific treatment, but extensive subcutaneous emphysema can be uncomfortable and alarming for the patient. It can rarely lead to airway compromise, respiratory failure and death. Factors leading to its development, following chest tube insertion and methods of management, have not been extensively studied and published. This was an analytical study done over a period of two years, on indoor patients who developed subcutaneous emphysema. These cases were managed using four different modalities and were analyzed for various factors contributing to the development, severity, and resolution of subcutaneous emphysema. Results of this study highlight that the cases of hydropneumothorax and secondary pneumothorax were significantly more predisposed to the development of severe subcutaneous emphysema (following intercostal chest tube insertion) and large air leak as compared to others. Larger air leak develops higher grades of subcutaneous emphysema. The average time for resolution of subcutaneous emphysema was similar among the different modalities of management compared in the study.