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The closed method of drainage and irrigation of an empyema cavity offers many advantages, chief of which are: 1. The method is simple and easy of operation, the insertion of a tube through a trocar under local anesthesia requiring only a few minutes. 2. The pressure within the cavity can be released at any desired rate. 3. There is little care in the form of dressings. 4. The cavity is not continually sucking air. 5. So long as the junction of the tube with the wall of the chest is air tight, suction can be applied, thus reducing the pressure within the empyema cavity below the surrounding atmospheric pressure and thereby decreasing the size of the cavity by expanding the lung.
On the other hand, many arguments have been advanced against this method of treatment. The most important has been that the drainage is inadequate; the pus, which becomes thick,
HART D. ACUTE EMPYEMA: TREATMENT BY CONTINUOUS TIDAL IRRIGATION AND DRAINAGE DEPENDENT ON NORMAL RESPIRATORY MOVEMENTS. Arch Surg. 1928;17(1):102–116. doi:10.1001/archsurg.1928.01140070105006
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