Despite being recognised for over two millennia and having an increasing incidence in many countries, the management of childhood empyema remains controversial. This review examines the recent literature on its causes and investigation then focuses on its treatment. Following a trial of appropriate intravenous antibiotics, the evidence would currently support the use of chest drain insertion wi...

The two-stage exchange arthroplasty (one- or two-stage) is believed to be the gold standard for the management of infections following total knee arthroplasty. We herein report a novel two-stage exchange arthroplasty technique using an antibiotic-impregnated cement intramedullary nail, which can be easily prepared during surgery using a straight thoracic tube and a Steinmann pin, and may provid...

Before inserting a chest drain, individual doctors should always ask themselves: • Do I need to do this? (The presence of a pneumothorax or pleural effusion does not automatically require insertion of a chest drain.) • Does it need to be done as an emergency or can it wait? (There are few indications for chest drain insertion as an emergency “out of hours.”) • Have I had enough training to feel...

The concentrations of aztreonam in human tissues obtained during surgery were measured after a single 2-g intravenous dose. The average concentration in the skeletal muscle, atrial appendage, lung, sternum, pericardial fluid, endometrium, myometrium, fallopian tube, and ovary varied from 3 to 33 micrograms/g (or microgram/ml). These concentrations significantly exceed the MIC for 90% of strains...

INTRODUCTION There is a lack of data evaluating the clinical effect on symptoms of pleural intervention procedures. This has led to the development of patient-reported outcome measures (PROMs) to define what constitutes patient benefit. The primary aim of this paper was to prospectively assess the effect of pleural procedures on PROMs and investigate the relationship between symptom change and ...

Abstract Introduction Neurological deficit associated with firearm injury outside the head and neck region is a rare phenomenon. Multiple explanations, including pellet embolization, patent foramen ovale carotid intimal tear, have been suggested. Case Report We present case of an otherwise healthy 21-year-old male, who was received in emergency injury, unstable vitals, GCS 14/15. Bullet entry w...

Although accidental hypothermia is considered a totally preventable cause of death, severe hypothermia (<28 o C) carries a mortality rate about 21%. That’s why conventional rewarming techniques such as using a warming blanket, warm intravenous saline, nasogastric lavage, continuous bladder irrigation and thoracic lavage via chest tubes are often considered inefficient and extracorporeal circula...

OBJECTIVE Clinical observation has identified cases in which the negative pressures exerted on patient chest drains have appeared to far exceed the level of suction intended. This study was designed to test whether the use of high rates of airflow in typical pleural/mediastinal drainage systems exerts excessively high negative pressures on the chest drainage tube. METHODS Three pleural draina...

UNLABELLED Over recent years there has been increasing usage of digital systems within cardiothoracic surgery to quantify air leaks and aid in clinical decision-making regarding the removal of chest drains postoperatively. The literature suggests improved agreement on timing of removal of chest drains and a reduced length of stay of patients. It could be that such devices could be useful tools ...

Although the use of chest drains is common in medicine, there appear to be wide variations in practice. A survey was therefore conducted to establish the current status of chest drain management in the Northwest region. A questionnaire targeted consultants practising in the specialties of chest medicine, general surgery, accident & emergency and cardiothoracic surgery. The questionnaire consist...