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. Two patients are presented in whom this scenario was presumed to have occurred. Early intervention in the second patient was felt to have avoided the development of a major empyema.