II. Following interventions/ dressing changes
fibrinous, empyema, purulent, infection
EMPYEMA, CAVITY, INFECTION
When a black sponge material was used, dressing changes were performed after 3–5 days. In the case of the white sponge material and open-pore film, the material was changed after 3–8 days. For dressing changes, less extreme positioning is required (usually in the supine or half-lateral position). Patients were either intubated or treated in analgo-sedation, depending on the comorbidities of the patient and risk assessment of the anaesthesiologists. The suction tube (endosponge) was removed, and an endoscope was inserted. The dressing material was removed using direct vision. The progress was evaluated and the cavity was rinsed with saline. Depending on the grade of granulation of the empyema membrane and the macroscopic cleanliness (purulent and/or fibrinous debris) of the cavity, the next procedure was planned according to the suction material chosen. In cases of slow progress, black sponges were repeatedly used. If good granulation was observed, the size of the inserted material was reduced, white sponge material was inserted in the regions where needed, and the therapy continued (Fig. Treatment success was monitored clinically using routine laboratory parameter analysis. In cases of systemic signs of infection, a CT scan was performed to identify parts of the empyema that were not adequately treated.