Empyema complicating muscle-sparing thoracotomy: the role of wound management.

The fascial layers bordering the latissimus dorsi and anchoring the serratus muscles often do not lend themselves to impervious closure during muscle-sparing thoracotomy. Fluid from the subcutaneous space may therefore drain into the pleural cavity after such procedures. If this fluid is contaminated with microorganisms the potential for development of empyema is present.

Differences in length of stay between coronary bypass and valve procedures.

Objective: Emphasis on cost reduction, national standardization of medical care, and quality improvement initiatives have led to reduced postoperative hospital stays after cardiac surgery. The present study was designed to verify the observation that valve patients have longer lengths of stay than bypass patients and to identify possible reasons.

Methods: The inpatient records of 26 consecutive patients who underwent valve procedures at our institution were reviewed and compared with the records of 25 consecutive coronary bypass patients.