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Infections after pleuro-pulmonary surgery.

H J Klippe, J Löhr, K von Windheim

    The Thoracic and Cardiovascular Surgeon
    |April 1, 1983
    PubMed
    Summary
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    Infectious complications after pleuro-pulmonary surgery have significantly decreased, with soft tissue infections dropping from 7% to 2%. However, mycotic superinfections are increasing, requiring greater attention.

    Area of Science:

    • Thoracic Surgery
    • Infectious Diseases

    Background:

    • Infectious complications pose a significant risk following pleuro-pulmonary surgery.
    • Historical data on infection rates are crucial for evaluating surgical practice improvements.

    Purpose of the Study:

    • To compare the incidence and causes of infectious complications after pleuro-pulmonary surgery over different time periods.
    • To assess trends in soft tissue infections, wound healing, empyemas, lung infections, and sepsis.

    Main Methods:

    • Retrospective analysis of infectious complication data from three distinct periods: pre-1968, 1968-1975, and 1978-1979.
    • Separate assessment of soft tissue infections, pleural cavity infections, and lung tissue infections.
    • Evaluation of postoperative empyemas, bronchial fistulae, lung abscesses, inflammatory atelectasis, bacterial sepsis, and mycotic superinfections.

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    Main Results:

    • Soft tissue infections decreased from 7% to 2%; secondary wound healing without infection fell from 21% to 5%.
    • Postoperative empyemas decreased from 4% to 1% in resections; lung abscesses became rare (0.2%).
    • Bacterial sepsis cases dropped to zero after 1973, while mycotic superinfections increased to approximately 3%.

    Conclusions:

    • Pleuro-pulmonary surgery has seen a marked reduction in bacterial infections, falling below general surgery averages.
    • Decortication for thoracic empyema still carries a relatively high risk of wound infection.
    • A shift towards increased vigilance for mycotic superinfections is necessary due to their rising incidence.