Yang Y.-H.Mok L.M.HAO-CHIH TAI2020-06-172020-06-1720191068-0640https://www.scopus.com/inward/record.uri?eid=2-s2.0-85071291064&doi=10.1097%2fCPM.0000000000000306&partnerID=40&md5=6c5e55dc98fa1c2f7716c9317c4749b1https://scholars.lib.ntu.edu.tw/handle/123456789/502750Empyema thoracis may be an ancient disease, but it still occurs in present-day thoracic practice. Despite medical and technical progression, pleural infection remains a major health care concern. When empyema thoracis is complicated by bronchopleural fistulae or repeated infections, it becomes a clinical challenge to physicians and can substantially lengthen and complicate a patient's course of treatment. This case report presents a 48-year-old male patient with chronic empyema and multiple bronchopleural fistulae who was effectively treated by a combination of a 1-way valve and vacuum-assisted closure system through open-window thoracostomy. This combination successfully prevented air accumulation beneath the wound dressing, and therefore it was possible to maintain negative pressure, which is essential for the vacuum-assisted closure system to function. ? 2019 Wolters Kluwer Health, Inc. All rights reserved.1-way valve; bronchopleural fistulae; empyema; open-window thoracostomy; vacuum-assisted closure[SDGs]SDG3amoxicillin plus clavulanic acid; erythromycin; Acinetobacter infection; adult; Article; bronchopleural fistula; case report; clinical article; computer assisted tomography; craniotomy; empyema; hemodynamics; human; male; middle aged; open fracture; respiratory failure; seizure; thoracostomy; thorax surgery; tracheostomy; traffic accidentjournal article10.1097/CPM.00000000000003062-s2.0-85071291064