Open window thoracostomy and plastic surgery with muscle flaps in the treatment of chronic empyema

Open window thoracostomy (OWT) and plastic surgery using myocutaneous flaps of extrathoracic muscles, was done in nine patients with chronic empyema, after conventional therapy had failed. In all these patients, the pleural cavity and bronchopleural fistulas, when present, closed within eight to 61 days (mean 30), after the second stage of surgery comprising the myoplasty; this in turn was performed between three to seven (mean 3.0) months after the OWT. All patients were considered cured with a minimal deformity of the chest wall. The final scar had an acceptable cosmetic appearance.