Use of hypertonic urea solution in the treatment of pleural empyema

Our experience covers 8 cases, all of them clinically severe. Prior to that all patients were treated without effect in different medical institutions. In 2 patients a pleural empyema was complicated by an extensive soft tissue phlegmon caused by medical manipulations (installation of a Bühlau drain). After suction of purulent contents through a puncture needle, 40 to 60 ml of 30% urea solution was injected into the pleural cavity. The same procedure was repeated 4-6 times in 1-2 days. Phlegmons were opened with lombard incisions. Dressings were done daily using the same 30% urea solution. All empyemas were sanitized to a dry pleural cavity. Phlegmons also healed without leaving deep scars.