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The surgical treatment of chronic empyema cavities and sinuses should be guided by two laboratory methods: The first, which is relatively the most important, is the bacteriologic examination of the discharge, and the second is a careful roentgenologic study of the existing pneumothorax. A proper correlation of these findings is necessary, however, to obtain satisfactory results; even though the bacteriologic control guides the surgeon in the correct use of neutral solution of chlorinated soda (Dakin's solution) and indicates that the cavity is sufficiently sterile either to allow healing or to permit a radical operation, the knowledge obtained by means of the roentgen ray is an absolute essential. It not only detects abnormalities in the lung tissue, but also demonstrates the size, shape and location of the draining cavity and affords some knowledge of the walls that surround it. This can be accomplished, however, only by a carefully standardized technic which
STEVENS FA. THE ROENTGENOLOGIC STUDY OF EMPYEMA CAVITIES. JAMA. 1918;71(24):1975–1977. doi:10.1001/jama.1918.26020500001006