Guided percutaneous drainage for posttraumatic empyema thoracis.
BACKGROUND
Guided percutaneous drainage (GPD) is used in the management of posttraumatic empyema thoracis; however, its equivalence to decortication has not been evaluated.


METHODS
We retrospectively reviewed the records of 12 patients who underwent GPD and nine who were treated with decortication.


RESULTS
No primarily GPD-managed empyemas necessitated a subsequent thoracotomy. The size and number of fibrinopurulent loculations treated by each technique were equivalent. Sterile purulent collections were found in 55.6% of decortication-treated patients and in 33% of patients who underwent GPD. Intrapleural analgesia was administered to 71.4% of decortication-treated patients and 28.6% of GPD-treated patients. Five patients undergoing decortication required intensive care unit monitoring after operation (average, 2.8 days), compared with no GPD-treated patients. The catheter was left in place at discharge in 41.6% of GPD-treated patients and was removed on an outpatient basis.


CONCLUSIONS
The efficacy of GPD in handling loculated pleural space infections equals that of decortication. An intensive care unit stay is avoided. The ability to discharge patients with external drainage catheters and the decreased requirement of pain control should reduce the number of inpatient hospital days. GPD is an effective first-line approach for posttraumatic empyema thoracis.
Block
E F
EF
Department of Surgery, University of Miami School of Medicine, FL 33101.
Kirton
O C
OC
Windsor
J
J
Kestner
M
M
D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004322:Drainage / Q000379:methods*; D016724:Empyema, Pleural / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000209:etiology; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000150:complications*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents