Infections after pleuro-pulmonary surgery.

The incidence and causes of infectious complications after pleuro-pulmonary surgery occurring in our institution before 1968, from 1968 to 1975, and from 1978 to 1979 are compared. Soft tissue infections occurring in the operative region, in the pleural cavity and in the remaining lung tissue are assessed separately. From these data it is concluded, that infections of soft tissue have markedly decreased from 7 to 2% while secondary wound healing without purulent infection has fallen from 21% to 5%. The risk of infection thus has decreased below the average figures of general surgery. A comparatively high number of wound infections however, have to be expected after decortication of thoracic empyema. The incidence of postoperative empyemas predominantly related to postoperative bronchial fistulae after lung resection has decreased from 4% to one percent in segmental or lobar resections. Serious infections of the remaining lung with abscess formation have become rare indeed (0.2%). Inflammatory atelectasis caused by bronchial obstruction has remained at a constance level of one to 2% throughout the years. There were 2 cases of lethal bacterial sepsis in 1,566 pulmonary procedures before 1973, but none thereafter. Increasing attention will have to be paid to mycotic superinfections rather than to primary bacterial infections since such superinfections of the tracheo-bronchial tree and of the pleural cavity have increased from less than one percent to approximately 3% during the recent 10 years.