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Haller and associates proposed that an index of greater than 3.25 constitutes a severe depression With the correction index, a value greater than 10% indicates a severe deformity.

Quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "The mainstay of treatment includes intravenous antibiotics for sepsis control, and drainage of the effusion to improve lung expansion. If initial medical management fails, then surgical intervention is necessary. The use of intrapleural fibrinolysis (urokinase, tissue plasminogen activator) via a chest drain can produce good results. The surgical options include thoracoscopic debridement, mini thoracotomy and debridement, and thoracotomy with decortication. Thoracotomy and decortication is reserved for advanced and chronic cases." Quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "Early diagnosis and treatment of the postpneumonic effusion will result in a better outcome. If the effusion is not improving with intravenous antibiotics, then early referral to a paediatric surgical centre is recommended. The early use of drainage and either intrapleural fibrinolysis or thoracoscopic debridement of the empyema can result in resolution in most patients. Thoracotomy and decortication is the procedure of choice if empyema is advanced or complicated."