After the report in 1946 by Samson and Burford, open procedures for empyema thoracis were often delayed until pleurodesis was assured if surgery could not be performed within the first three weeks. Eloesser subsequently developed an ingenious flap technique to drain the empyema cavity after it was allowed to mature to the point of ensuring complete pleurodesis. Although this technique reduced morbidity, returned adequate pulmonary function and provided a cosmetically acceptable result, it prolonged postoperative hospitalization increased the burden of costly wound care and frequently necessitated secondary procedures for wound closure.
Early thoracotomy for empyema has been reported by a number of authors with appropriate emphasis on tailoring therapy to the individual patient. Morin and co-workers in 19726 reported their results in 23 patients who underwent early surgical intervention with excellent results. Except for one death in an elderly patient, which was unrelated to surgery, there were no complications, and the average postoperative hospital stay was two weeks. This result was similar to our average postoperative stay of ten days. The lower average age of our patients (five of seven patients less than 33 years old) probably accounts for the differences in the length of stay between the two reports.