GUIDED PERCUTANEOUS DRAINAGE FOR POSTTRAUMATIC EMPYEMA-THORACIS

Background. Guided percutaneous drainage (GPD) is used in the manageme nt of posttraunatic empyema thoracis; however, its equivalence to deco rtication has not been evaluated. Methods. We retrospectively reviewed the records of 72 patients who underwent GPD and nine who were treate d with decortication. Results. No primarily GPD-managed empyemas neces sitated a subsequent thoracotomy. The size and number of fibrinopurule nt loculations treated by each technique were equivalent. Sterile puru lent 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 G PD-treated patients. Five patients undergoing decorticatian required i ntensive care unit monitoring after operation (average, 2.8 days), com pared 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 outpa tient basis. Conclusions. The efficacy of GPD in handling loculated pl eural space infections equals that of decortication. An intensive care unit slay is avoided. The ability to discharge patients with external drainage catheters and the decreased requirement of pain control shou ld reduce the number of inpatient hospital dalls. GPD is an effective first-line approach Sor posttraumatic empyema thoracis.