Transcostal approach for closed pleural drainage

Chronic empyema, long course of disease, poor drainage through the intercostal space. Treatment of diseases: tension pneumothorax Indication Chronic empyema, long course of disease, poor drainage through the intercostal space. Contraindications The age of the body is weak, the vital organs such as the heart and lungs are poor, and the surgery does not restore hope. Preoperative preparation 1. Tension pneumothorax should be immediately given to the pleural cavity decompression, in order to obtain preparation time before surgery. 2. Traumatic hemothorax needs to be prepared for whole blood at the same time. Surgical procedure 1. The incision is positioned at the bottom of the abscess. 2. Make a 6-7 cm incision along the rib. Cut the muscle wall of the chest wall to reveal the ribs. Cut the periosteum and cut off a length of 3 to 4 cm ribs. 3. After the diagnosis of the puncture puncture, the incision is incision, the size and shape of the abscess are probed by the fingers, and the fibrous adhesion is separated to make it a large cavity. Place the tube at the bottom of the abscess and connect the water to the bottle. After 2 to 3 weeks, if the abscess is still not closed, the drainage tube can be cut outside the skin to open drainage. complication Those who have a large amount of gas and fluid in the pleural cavity should be slow when opening the drainage. A rapid swing shift of the mediastinum or the occurrence of recurrent pulmonary edema occurs. After the condition is stable, gradually open the hemostatic forceps.

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