The picture shows a gaping wound on the chest with the ribs exposed, pus oozing inside and air coming out of the wound.
This patient had a close tube thoracostomy ( a tube inserted into the lungs) for PNEUMOTHORAX ( accumulation of air in the thoracic cavity outside the lungs) because of tuberculosis. The tube was not taken out immediately ( about 7-10 days) after evacuation of the air ( thru chest x-ray). It stayed inside far too long ( 1 month). She developed EMPHYEMA ( pus formation in the lungs). From a simple air to development of pus, this is a human mistake which cannot be taken for granted.
When she was referred to me, this was her chest x-ray.
The left lung collapsed; fluid ( pus) filled the cavity up to the 3rd rib. The heart is pushed to the right and the cavity still has air.
I removed the old tube which was not draining and inserted a new one. Then I closed the wound to prevent air from entering the wound. After surgery, no leakage was noted; pus drained out thru the tube. I sent the patient home. All of these procedures done in my clinic saving the patient a year's salary of her father.
A week later, she came back with an open wound; the tube hanging on her side by a thread and pus oozing out from the wound. Suture again and close the wound? That I did. 4 days later, the wound dehisced with pus flowing on her side. I removed the chest tube; debride the area and packed the wound to allow the pus to drain out.
10 days later, she came back well looking, pinkish on the face; not dyspneic anymore and she is on her way to recovery. Allowing the human body to heal itself is the best decision that I made for this patient.
Doc: Thanks for photos and sharing. :-)
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