Management of the Unhealed Perineal Wound After Proctectomy

Abstract

Empyema thoracis has remained a persistent clinical challenge since being described in the Hippocratric corpus.1 Fundamental therapeutic goals are well established: removal of infected fluid, disruption of loculations, and lung re- expansion. Historically, surgical therapy was accomplished with chest tube drainage and/or thora cotomy. The advent of video assisted tho- racic surgery (VATS), fibrinolytic agents, and image guided catheter placement techniques pro- vides an increased array of options. Appropriate therapeutic options are based on the characteris- tics of the empyema. However, there is a frustrat- ing lack of standardization in the literature relative to empyema staging