Decortication easy for Delorme
Pulmonology / / April 27, 2016
Operations on chest wall and chest cavity
(method of operation)
Depending on the patient's cavity empyema localization is placed in one of the typical provisions for thoracotomy - anterolateral, lateral or posterolateral.In total empyema surgeon stands on the side where the patient is turned back, at the location of the limited empyema in the posterior pleural cavity the surgeon gets from his chest.
1. Access. For small and medium-sized empyema cuts out the skin-muscle-flap rib respectively cavity boundaries.Throwing him and wrapped wet wipes moistened with isotonic sodium chloride solution, proceed to cleanse the empyema cavity of pus and loose fibrinous deposits.For large amounts of residual cavity such access would be too traumatic.Therefore, the operation is performed through one of the standard thoracotomy with resection of the ribs.If necessary, cross the cartilage upstream and downstream edges.To cleanse the space necessary to prepare a metal tip for electric pumps a
2. Isolation of the lung. scalpel incised scar tissue to visceral pleura.Entering the desired layer, small dense cotton swab gently emit light.Sister often changes the cotton swab, as they quickly osliznyayutsya and begin to slide.In those places where it is not possible to separate the seam cotton swab, the surgeon dissects them with scissors.If it is impossible to separate the fibrous tissue scissors without significant lung damage, incised with a scalpel in its different directions.It provides a smoothing of the lung tissue with increased volume ventilation anesthesia machines.If, in spite of the produced decortication, is not easily cracked down and does not fill the entire volume of the pleural cavity, the operation can be completed thoracoplasty.Operating sister should know about it in advance and prepare the necessary tools.
remaining steps are the same as in the lung resection.
If decortication supplemented thoracoplasty impose a pressure bandage to tight cotton-gauze roll over the resected ribs.