During the last three or four years, there has been a return to closed methods of drainage for empyema, with a rather more widespread adoption of these principles than on any of the previous occasions when this form of treatment had been adopted only to be discarded again partially. It is our belief that the causes of this widespread change or modification in treatment are the occurrence of streptococcus empyema in army camps, with a very high mortality attendant on rib resection, and the very prevalent misconception as to the action of the lungs in the presence of an open thorax. That there is some merit in draining pus from the chest, without leaving the pleural cavity open to the air, is apparent. From a study of the literature and an analysis of 172 of our own cases in which operation was done during what might be called this transitional
LADD WE. EMPYEMA IN CHILDREN: WITH ANALYSIS OF ONE-HUNDRED AND SEVENTY-TWO CASES. Am J Dis Child. 1921;21(6):546–551. doi:10.1001/archpedi.1921.01910360029004
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