Posttraumatic Empyema

Abstract

The extent of pulmonary injury (pulmonary contusion) is an important predictor of empyema development. Previously implicated factors such as setting in which a TT was performed and mechanism of injury did not correlate with the development of posttraumatic empyema. Based on the results of our study, we recommend early drainage of the pleural space with video-assisted thoracoscopic techniques in patients at risk of empyema, which may spare them the morbidity of a thoracotomy.

Prophylactic Antibiotics in Chest Trauma: A Meta‐analysis of High‐quality Studies

“…There is a tendency to think that the presence of a chest tube in the pleural space might favor the onset of empyema and that, consequently, antibiotics should be used over the entire thoracostomy period. However, some authors have determined that the most important factor for the development of empyema is incomplete drainage, 17,18 and in spite of using antibiotics, if the chest tube does not drain adequately, all other interventions are meaningless. On the other hand, the evidence available from the subgroup analysis for the outcome of pneumonia suggests that the use of antibiotics should continue for more than 24 hours, at least during the time the chest tube is in place, as determined by trial protocols.…”

“…There is a tendency to think that the presence of a chest tube in the pleural space might favor the onset of empyema and that, consequently, antibiotics should be used over the entire thoracostomy period. However, some authors have determined that the most important factor for the development of empyema is incomplete drainage,17,18 and in spite of using antibiotics, if the chest tube does not drain adequately, all other interventions are meaningless.…”

Delayed hemothorax following blunt thoracic trauma: a case report

“…The utility of routine evacuation of hemothorax following blunt trauma in general remains controversial. Blunt etiology of hemothorax is considered less likely to result in infection; however, retained hemothorax following blunt trauma is an established risk factor for empyema [ 9 ]. Surgery is needed in 0.4% of cases, as most cases are managed through closed thoracostomy [ 5 ].…”

Chest Trauma

“…Residual blood is a nidus for the development of empyema and fibrothorax, which can also occur due to improper positioning or obstruction of the chest tube [ 4 ].…”