noxythiolin and Empyema

A technique of irrigation for the management of empyema thoracis is described. Initial thoracoscopy using a laparoscope under general anaesthesia enabled adequate debridement and breakdown of loculi within the empyema cavity under direct vision. Following this procedure irrigation of the cavity with two tubes was started and continued until three consecutive cultures of drained irrigation fluid became sterile. The procedure was then discontinued. The results in 14 patients are presented using this method, irrigation was required for an average of 14 days. Patients remained in hospital for an average of 4.8 weeks. Tuberculous empyema was not found to be a contra-indication to the irrigation technique.

Topics: Adult; Aged; Chest Tubes; Empyema; Female; Humans; Male; Middle Aged; Noxythiolin; Therapeutic Irrigation; Thoracoscopy

Topics: Empyema; Humans; Noxythiolin; Pleura; Pleural Effusion; Therapeutic Irrigation

A new method of treating pleural empyema or pneumonectomy space infection by irrigation was evaluated in 11 patients. The infected cavities were filled with an antibiotic or antiseptic solution for three hours, and allowed to drain for one hour. This cycle was repeated every four hours for seven to 10 days. When cultures of the infected cavity became sterile the irrigation tube was removed and the wound sealed. Using this method, infection was eradicated after an average of 11 days in five of six patients with pleural empyema and in all five patients treated for an infected pneumonectomy space, including one with a bronchopleural fistula. The results of treating 58 similar cases of intrapleural sepsis over a 10-year period by the standard methods of aspiration, open drainage, decortication, or thoracoplasty were compared with the results of irrigation. In general, cyclical irrigation resulted in a shorter hospital stay and a shorter period of wound drainage than other methods.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Drainage; Empyema; Female; Humans; Male; Middle Aged; Noxythiolin; Pneumonectomy; Surgical Wound Infection; Therapeutic Irrigation; Thoracoplasty