Pleurocutaneous flap: how useful it is in management of chronic empyema

BACKGROUND: Definitive surgical treatment of chronic empyema is associated with considerable morbidity and mortality. Methods. Retrospective study of 50 patients with chronic empyema who underwent pleurocutaneous flap procedure during the period 1994 to 2003. RESULTS: Their age ranged from 14 to 70 years; there were 32 males. Thirty-seven (74%) patients were on intercostal tube drainage; nine (18%) presented with bronchopleural fistula; and four (8%) had past-pneumonectomy empyema. Following pleurocutaneous flap procedure, 28 (56%) responded with re-expansion of the lung; 15 (30%) had persistence of pus discharge and air-leak suggestive of bronchopleural fistula. Definitive surgery could be undertaken in nine of the 15 patients. CONCLUSIONS: Pleurocutaneous flap procedure renders the patient ambulatory, facilitates re-expansion of the lung and helps as a tide-over procedure before definitive surgery in patients with chronic empyema.