Methods for the curative treatment of pleural empyema with bronchial fistulae in patients with pulmonary tuberculosis

: In contrast to non-specific pleural empyemas in which closed sanitization is sufficiently beneficial, an early application of thoracostoma is essential for patients with tuberculous pleural empyema with bronchial fistulas. Thoracostoma allows for effective sanitization of the cavity, long-term antituberculous chemotherapy and preparation of patients for radical operations. This has been supported by the comparative analysis of the outcomes of radical operations in 139 patients following closed and open management of the empyemic cavity in pulmonary tuberculosis. The site of thoracostoma is defined depending on the location and volume of an abscess and the forthcoming radical operation. Long-acting antiseptic dressings containing chlorohexidine bigluconate, which are based on the polymer polyhydroxyethyl methacrylate and which have been developed in the clinical setting, and ultraviolet irradiation with a unique-design apparatus are proposed for sanitization of open pleural empyemas.