almost invariably heal after dependent drainage of the empyema.
(2)
Failure of the lung to re-expand and obliterate the empyema
cavity.-—See "Chronic Empyema".
(3)
Infection of the chest wall.—Before antibiotics were used
locally to control the infection in empyemas, it was common to see an abscess
in the chest wall at the site of a previous paracentesis, but such cases are
now rare. In a few instances, spreading infective necrosis of the skin has been
observed, usually after drainage of the empyema. These serious cases should be
treated by immediate excision of the affected tissue with the diathermy knife,
and the raw area so caused should be subsequently grafted with skin.
(4)
Haemorrhage from the intercostal
vessels, following drainage of the empyema. —This rare complication may be recognized by the
occurrence of persistent and profuse haemorrhage around the tube. The tube
should be removed at once and the wound packed with a gauze roll. The patient
is then taken to the operating theatre so that the wound may be re-opened and
the vessels ligated. Some surgeons claim that this complication does not occur
if the vessels are routinely divided between ligatures at the time of draining
the empyema.
(5)
Brain abscess.—Because it is rare for a straightforward acute
empyema to give rise to a cerebral, abscess, this complication is considered at
the end of the discussion on chronic empyema.
