Week Six - Abscesses, Carbuncles, and Pilonidal Cysts Flashcards
What are the common locations for abscesses to occur?
Areas prone to friction or minor trauma
- Underneath a belt
- The anterior thighs
- Buttocks
- Groin
- Axillae
- Waist
- Proximal phalanges of the fingers
It commonly takes ____ to ____ days for an abscess to become fully “ripe,” complete with central core of necrosis
- 4 to 6 days
If an abscess is not a hollow sphere, what is it?
- It is a cavity formed by fingerlike loculations of granulation tissue and pus that extends outward along planes of least resistance
In individuals with recurring abscesses, the infecting strain of bacteria may be found during quiescent periods in the _____, _______, _______, and/or the ______, known as the “incubator” sites
- Nares (primary site of dissemination of staphylococcus to the skin)
- Axillae
- Perineum
- Navel
What does the microbiology of abscesses reflect?
- The microflora of the anatomic part of the body involved
Approximately _____% of abscesses become sterile - some without antimicrobial treatment
- 5%
How does furunculosis occur?
- As a self-limited infection in which one or several lesions are present, or as a chronic, recurrent disease that lasts for months or years, affecting one or several family members
What are the various predisposing factors for abscesses and furuncles?
- Traumatic inoculation of bacteria into the skin by a puncture wound, laceration, or surgical incision
- Skin exposure to deodorants and other irritants
- Poor hygiene is the most significant factor
- Local causes of pruritis, such as insect bites and pediculosis capitis
- Excessive sweating of the hands, feet, and intertriginous sites
- Climactic factors, primarily hot humid areas
- Immunodeficiency states
- Perhaps diabetes mellitus
- Atopic dermatitis, eczema, and scabies
The preferred sites for the development of carbuncles are _____ _____, _______ ________, and _______ _______
- Back of the neck
- Back of the trunk
- Lateral aspects of the thighs
Principal therapy of an abscess is still _____ and ______
- Incision and drainage
What is “advancing the drain?”
- If a drain has been placed in the opening after incision of an abscess, one option is to gradually “advance” the drain out of the opening and trim off a portion each day
Can abscesses resolve without incision and drainage?
- Yes
- Untreated abscesses often spontaneously rupture and drain, or if early and small, may shrink and resolve completely without incision and drainage
Pilonidal cysts typically present with a draining sinus in the midline and usually a secondary opening, almost always ___ to ____ cm cephalad and to one side
- 2.5 to 5 cm (1 to 2 inches)
What is the conservative treatment for pilonidal cysts?
Simplest forms of home treatment are often best
- Loose weight clothing
- Keep the area clean - daily gentle washing with a washcloth
- Carefully remove any protruding hair on a regular basis
- Avoid wearing tight clothing
- Hot water baths/compresses, tea bag compresses, or alternating hot/cold may lead to spontaneous drainage
- Potato, carrot, etc. poultices
- Zinc, multivitamin supplements
- Hepar sulphuris homeopathic
_____ is the preferred surgical treatment for a new pilonidal cyst
- Incision and drainage
