Incision and Drainage of abscess

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When choosing anaesthesia the following factors have to be kept in mind:

  • Children

  • Deep seated abscess

  • Abscess in relation to bony injuries

  • Most frequently seen subcutaneous abscesses, particularly located in the extremities and trunk particularly in adults may be reasonably handled under local anaesthesia

    using 1% xylocaine.

  • Whenever GA is used:

  • It is better that surgery is carried out with adequate O.T. facility.

  • It is very important to make sure that patient is in empty stomach before general anaesthesia is induced.

  • In dealing with the elderly and those with cardiac and other problems, appropriate monitoring may be required.

  • Use of ethyl chloride spray to incise and drain an abscess by freezing the surface is not recommended for the following reasons:

    • This is a highly inflammable material

    • The anaesthesia is inadequate

    • It cannot be used in locations particularly face etc.

    • Risk of damage due to frost bite (eyes).

It may be used to a very limited extent in fluctuating superficial abscesses where a quick procedure is possible.

Local anaesthesia : Procedure

  • Re-assure the patient and explain the procedure to be done; get appropriate cosultation, take adequate precautions in terms of patient, healthcare personnel etc., (AIDS, Hepatitis etc) _ universal precautions.

  • Requirements _ adequate lighting, clean room, surgeon and assistants to wash hands and use cap, mask and sterile gloves. Prepare the skin surface adequately with povidone iodine, use sterile drape around the abscess site.

  • Carefully plan and administer pre operative analgesics and sedation.

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knaidoo 

I CURRENTLY HAVE MULTIPLE ABCESS ON MY HEAD THAT HAS PUS AND ITS PAINING ALOT.

dr.prash 

Can 1%xylocaine be used in inflammed parts?

Stevie 

I currently have an abscess on my face in my left cheek. I have had to IV drips and am on oral antibiotics. The dr made a little cut in my face to drain it. I have been bak 2 days now and have had it squeezed and more gauze put in but it doesn't seem to be getting any better, If anything I think it's getting worse. Can someone tell me if I can get it drained because of where it is on my face? As my doctor is unsure of this.

drakshay 

why not wait till fluctuation appears in areas like breast, parotid and perirectal area?

Carlos5 

I saw a pt in my clinical with a cellulitis questionable MRSA infection.
there was a pinpoint area of puss then 1cm out and around the area was an area of induration then about 1.5 inches out from the pinpoint area of puss the skin was erythemic. should this have had an I & D?

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