In June Okada et al. (2105) reported on the efficacy of partial pleural covering to the reduce the incidence of recurrent pneumothorax in BHD patients. A new report from Ebana et al. (2015) discusses the success of this treatment in an additional patient; a 30 year male, genetically confirmed to have BHD, who suffered three pneumothoraces in under two years. CT imaging identified numerous pulmonary cysts in his left lung including some in close proximity to pulmonary vessels.

Due to the number and location of the pulmonary cysts it was decided that the removal of all cysts was not feasible. Instead staples and ligation were used to complete a preliminary partial bullectomy. Subsequently a regenerative oxidisied cellulose (ROC) mesh was applied to the entire surface of the left lung and sealed with fibrin glue. The patient has not suffered any additional pneumothoraces in the year since surgery. This report therefore offers more support to the use of pleural covering as an effective alternative to pleurodesis in patients with recurrent pneumothorax.