The fascial layers bordering the latissimus dorsi and anchoring the serratus muscles often do not lend themselves to impervious closure during muscle-sparing thoracotomy. Fluid from the subcutaneous space may therefore drain into the pleural cavity after such procedures. If this fluid is contaminated with microorganisms the potential for development of empyema is present. Two patients are presented in whom this scenario was presumed to have occurred. Early intervention in the second patient was felt to have avoided the development of a major empyema.
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References
1.
TovarEA, RoetheRA, WeissigMD, . Muscle-sparing minithoracotomy with intercostal nerve cryoanalgesia: An improved method for major lung resections. Am Surg1998;64:1109–14.
2.
RothenbergSS, PokornyWJ. Experience with a total muscle-sparing approach for thoracotomies in neonates, infants and children. J Pediatr Surg1992;27:1157–60.
EdlichFE, RodeheaverGT, ThackerJG. Technical factors in the prevention of wound infections. In: HowardRJ, SimmonsRL, editors. Surgical Infectious Diseases. 3rd ed. Norwalk, CT: Apple-ton & Lange, 1995, pp 423–62.
5.
KrizekTJ, DavisJH. The role of the red cell in subcutaneous infection. J Trauma1965;5:85–95.
6.
BhattacharyyaN, UmlandET, KosloskeAM. A bacteriologic basis for the evolution and severity of empyema. J Pediatr Surg1994;5:667–70.
7.
MavroudisC, GanzelBL, KatzmarkS, PolkHCJr. Effect of hemothorax on experimental empyema thoracis in the guinea pig. J Thorac Cardiovasc Surg1985;89:42–9.