Incision and Drainage Flashcards
Organism most often involved with skin abscesses
s. aureus
Superficial infection of the hair follicles in the epidermis. Usually resolve spontaneously – warm compresses. Avoid shaving.
folliculitis
collection of pus within dermis and deeper skin tissues
skin abscess
Infection of hair follicle – pus extends thru dermis into subQ tissue
furuncle (boil)
Coalescence of several infected follicle into single mass with several draining sites
carbuncle
Patients who need antibiotic prophylaxis before having an abscess drained
those who have had heart valve or total joint replacements
Abx for: abscess > 5 cm, extensive cellulitis, signs systemic infection, comorbidities, immunosuppression, prosthetic joints and valves
clindamyin or doxycyline
Abx for suspected MRSA
vanco
Besides abx, what else might a patient need prophylactically before and I&D?
tetanus if indicated by vaccination status
Local anesthesia usually sufficient for most simple abscesses. Short and long acting. More effective as a field block
lidocaine and bupivicaine
may be needed for children and those with large abscesses due to administration of additional anesthetic.
IV Demerol and Phenergan
Type of incision to avoid in I&D
cruciate
Where should the pus culture come from?
within the wound
Should an abscess be closed after drainage?
best left open esp in Immunocompromised, systemic infection, significant cellulitis
If you do close an abscess what is the best type of stitch to use?
vertical mattress
