Management of complicated postoperative air-leak - a new indication for the Asherman chest seal.

Postoperative air-leak is a problem which is frequently encountered in thoracic surgery. We describe the utility of the Asherman chest seal, a device used in primary trauma care in the successful management of a complicated postoperative air-leak. The Asherman Chest Seal is a sterile occlusive dressing with a one-way Heimlich valve for treating open pneumothorax in acute settings. We used the Asherman chest seal in six patients from July 2001-June 2006 for management of persistent air-leak following thoracic surgical procedures. It was used in three decortication and three pleurectomy patients. There was an equal sex distribution with an age range of 24-67 years. The chest seal was used when drains fell out in the presence of air-leak or wound infection resulting in pneumothorax. All six patients had satisfactory expansion of the lungs with cessation of the air-leak. This was achieved without the pain and morbidity of a chest drain and inpatient stay. The Asherman chest seal is a simple but very useful device that has a role in management of complex air-leaks.