If all the potential causes of delayed healing could be recognized and obviated during the acute stage, there should be no chronic empyema. It must be admitted that a cause of delayed healing may be very obscure, and that, even if recognized, it may be impossible to remove it. However, in most cases the cause is recognizable, and more can be accomplished in preventing chronic empyema by the removal of the cause of delayed healing during the acute stage than can be accomplished by the later cure. Intelligent and rational treatment of the chronic condition must be based on an understanding of the underlying cause. An inquiry into the causes of delayed healing is, therefore, pertinent to the consideration of both prevention and cure.
This paper is based on a study of 310 cases at the Mayo Clinic during the last five years. The age incidence and the duration of
HEDBLOM CA. CAUSATIVE FACTORS AND TREATMENT OF CHRONIC EMPYEMA. JAMA. 1923;81(12):999–1005. doi:10.1001/jama.1923.02650120031008