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Ann Thorac Surg 1981;31:464-468
© 1981 The Society of Thoracic Surgeons

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Articles

A Method of Early Irrigation of the Contaminated Postpneumonectomy Space

Department of Surgery, the University of Alabama in Birmingham, the Medical Center, Birmingham, AL

Accepted for publication June 16, 1980.

^* Address reprint requests to Dr. Katz, Department of Surgery, Georgetown University Hospital, 3800 Reservoir Rd, NW, Washington, DC 20007

A modified balanced drainage system was used with other measures in a patient with an obstructing pulmonary carcinoma, infection, and necrosis. Management included right pneumonectomy, perioperative systemic antibiotics, protection of the remaining lung, and a modified balanced drainage system that allowed early irrigation of the postpneumonectomy space. On the tenth postoperative day, irrigations were discontinued, the right chest was filled with an antibiotic solution, and the thoracostomy tubes were removed. The mediastinum remained in a satisfactory position, and the patient recovered without evidence of empyema. He died of a cerebral metastasis five and a half months postoperatively.

This method combines principles that have been used for many years. A balanced drainage-irrigation system permits early irrigation of the contaminated postpneumonectomy space while the mediastinum is still mobile. Prolonged hospitalization and formal closure of the thoracostomy sites can be avoided.

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