16Management Control of the Infection process. Drainage of pus form the pleura.Obliteration of the space & complete Re-expansion of the Lung.
17Drainage of Empyema Intercostal tube thoracostomy. Intrapleural instillation of streptokinase .V.A.T.S.Rib Resection Drainage.Eloesser Flap .
18Tube thoracostomy Indications Technique When to remove When to convert to open drainage
19Intrapleural Streptokinase IndicationsAcute or fibrino purulent stagePresence of loculations.Incomplete drainage after tube insertionContraindications:Chronic stagePost-operative empyemaEmpyema with BPF.
20Technique Streptokinase 25000 iu in 50 cc of 0.9% saline solution. Clamp the tube for 6 hours.Open the clamp and connect tube to suction