Management of life-threatening subcutaneous emphysema using subcutaneous penrose drains and colostomy bags.

Subcutaneous emphysema is a common complication post cardiothoracic surgery. Severe subcutaneous emphysema may cause respiratory obstruction and sometimes tracheostomy or intubation is required. We report a case of massive subcutaneous emphysema following aortic valve replacement. It was not relieved with initial bilateral chest tubes, but the subcutaneous Penrose drains produced a dramatic improvement and provided effective decompression of the subcutaneous emphysema. We also describe the colostomy bags, which covered the drains. These were useful for keeping the area sterile and measuring the amount of air through the individual drains.