Incision and Drainage Flashcards
1
Q
What are the indications for I and D?
A
- Treatment of localized abscess
2. remember fluctuance indicates abscess
2
Q
What are the contra-indications for I and D?
A
- Infection without abscess
- Infection that is not fluctuant
- Facial furuncles located within triangle formed by bridge of nose & corners of mouth
3
Q
What equipment is needed for I and D?
A
- Antiseptic solution
- Needle & syringe for local anesthesia
- 25 – 30 gauge needle
- 1% lidocaine
- Scalpel #11 blade
- Sterile 4x4 gauze
- Curved hemostats
- Iodoform packing
- Sterile cotton swabs
4
Q
What is the procedure for I and D?
A
- Wash your hands
- Cleanse area with antiseptic solution
- Drape in sterile fashion
- Administer anesthetic
- Puncture the skin over the fluctuant area
- Make a sufficiently wide incision to allow abscess to drain
- Probe inside abscess with sterile swab; cultures can be obtained at this time
- Express purulent material
- Irrigate cavity with sterile normal saline
- Pack cavity with iodoform packing strips
- Cover with sterile dressing
- Arrange appropriate follow-up care
5
Q
How is the anesthetic administered?
A
- Avoid infiltrating abscess cavity
- Slowly introduce needle into subdermal tissue and aspirate to be sure you’re not in vessel
- Slowly inject anesthetic while withdrawing the needle
- Continue to anesthetize the perimeter of the involved area
- Wait until area is fully anesthetized
6
Q
What is the post-procedure care for I and D?
A
- Change packing daily
- Watch for the following (and report):
A. Increasing infection
B. Recollection of pus in abscess
C. Fever & chills
D. Increased pain or redness
E. Red streaks near site
F. Increased swelling in area
7
Q
What potential complications may arise from an I and D?
A
- Bacteremia
- Neurovascular injury
- Spread of infection
- Scar formation
- Recurrence of infection
