Incision and drainage - Revision history

Rossdonaldson1: /* Indications */

2024-12-11T16:35:35Z

Indications

← Older revision		Revision as of 16:35, 11 December 2024
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	==Indications==		==Indications==
			{{Skin anatomy background images}}
	*[[Abscess]] of skin or superficial soft tissue		*[[Abscess]] of skin or superficial soft tissue

Rossdonaldson1: /* Procedure */

2021-07-07T17:57:21Z

Procedure

← Older revision		Revision as of 17:57, 7 July 2021
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	==Procedure<ref name="NEJM" />==		==Procedure<ref name="NEJM" />==
	[[File:PMC2453116 1472-6920-8-38-3.png\|thumb\|A) A scalpel is used to incise the abscess. B) Hemostat and culture swab are used to break up loculations within the interior of the abscess cavity. C) Wound packing material is inserted into the abscess cavity.]]		[[File:PMC2453116 1472-6920-8-38-3.png\|thumb\|Standard technique: A) A scalpel is used to incise the abscess; B) Hemostat and culture swab are used to break up loculations within the interior of the abscess cavity; C) Wound packing material is inserted into the abscess cavity.]]
	===Standard Technique===		===Standard Technique===
	''Sterile technique recommended, but not required''		''Sterile technique recommended, but not required''

Rossdonaldson1: /* Procedure */

2021-07-07T17:56:49Z

Procedure

← Older revision		Revision as of 17:56, 7 July 2021
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	==Procedure<ref name="NEJM" />==		==Procedure<ref name="NEJM" />==
			[[File:PMC2453116 1472-6920-8-38-3.png\|thumb\|A) A scalpel is used to incise the abscess. B) Hemostat and culture swab are used to break up loculations within the interior of the abscess cavity. C) Wound packing material is inserted into the abscess cavity.]]
	===Standard Technique===		===Standard Technique===
	''Sterile technique recommended, but not required''		''Sterile technique recommended, but not required''

Elcatracho: /* Follow-up */

2021-03-31T03:03:17Z

Follow-up

← Older revision		Revision as of 03:03, 31 March 2021
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	*7-day course of [[Trimethoprim–Sulfamethoxazole]] has been shown to decrease treatment failure<ref>Talan DA, et al. Trimethoprim–Sulfamethoxazole versus placebo for uncomplicated skin abscess. NEJM. 2016; 374(9):823-832.</ref>		*7-day course of [[Trimethoprim–Sulfamethoxazole]] has been shown to decrease treatment failure<ref>Talan DA, et al. Trimethoprim–Sulfamethoxazole versus placebo for uncomplicated skin abscess. NEJM. 2016; 374(9):823-832.</ref>
	**Previously [[antibiotics]] were indicated only for 1) overlying cellulitis; 2) evidence of systemic infection<ref>Fahimi J, Singh A, Frazee BW. The role of adjunctive antibiotics in the treatment of skin and soft tissue abscesses: a systematic review and meta-analysis. CJEM. 2015 Feb 20:1-13.</ref>; for immunosuppressed patients; or [[abscess]] that does not respond to standard treatment <ref>Singer A, Talan D. Management of Skin Abscesses in the Era of Methicillin-Resistant Staphylococcus aureus. N Engl J Med 2014; 370:1039-1047</ref>		**Previously [[antibiotics]] were indicated only for 1) overlying cellulitis; 2) evidence of systemic infection<ref>Fahimi J, Singh A, Frazee BW. The role of adjunctive antibiotics in the treatment of skin and soft tissue abscesses: a systematic review and meta-analysis. CJEM. 2015 Feb 20:1-13.</ref>; for immunosuppressed patients; or [[abscess]] that does not respond to standard treatment <ref>Singer A, Talan D. Management of Skin Abscesses in the Era of Methicillin-Resistant Staphylococcus aureus. N Engl J Med 2014; 370:1039-1047</ref>
			**[[Clindamycin]] shown to be as effective as TMP/SMX, but with higher adverse events<ref>Daum RS, Miller LG, Immergluck L, et al. A Placebo-Controlled Trial of Antibiotics for Smaller Skin Abscesses. N Engl J Med. 2017;376(26):2545-2555. doi:10.1056/NEJMoa1607033</ref>

	==See Also==		==See Also==

Elcatracho: /* Equipment Needed */

2021-03-27T02:25:35Z

Equipment Needed

← Older revision		Revision as of 02:25, 27 March 2021
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	==Equipment Needed==		==Equipment Needed==
	*PPE		*PPE
	*[[Local anesthetic]]		*[[Local anesthetics\|Local anesthetic]]
	*Incision and Drainage Tray:		*Incision and Drainage Tray:
	**Scalpel		**Scalpel

Elcatracho: /* Equipment Needed */

2021-03-27T02:23:29Z

Equipment Needed

← Older revision		Revision as of 02:23, 27 March 2021
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	==Equipment Needed==		==Equipment Needed==
	*PPE		*PPE
	*Local anesthetic		*[[Local anesthetic]]
	*Incision and Drainage Tray:		*Incision and Drainage Tray:
	**Scalpel		**Scalpel

Elcatracho: /* Follow-up */

2021-03-27T02:21:32Z

Follow-up

← Older revision		Revision as of 02:21, 27 March 2021
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	*Wound check in 1-2 days.		*Wound check in 1-2 days.
	*Warm soaks to help facilitate ongoing drainage		*Warm soaks to help facilitate ongoing drainage
	*7-day course of [[Trimethoprim–Sulfamethoxazole]] ~~for all abscesses post incision and drainage (~~to ~~prevent~~ treatment failure)<ref>Talan DA, et al. Trimethoprim–Sulfamethoxazole versus placebo for uncomplicated skin abscess. NEJM. 2016; 374(9):823-832.</ref>		*7-day course of [[Trimethoprim–Sulfamethoxazole]] has been shown to decrease treatment failure<ref>Talan DA, et al. Trimethoprim–Sulfamethoxazole versus placebo for uncomplicated skin abscess. NEJM. 2016; 374(9):823-832.</ref>
	**Previously [[antibiotics]] were indicated only for 1) overlying cellulitis; 2) evidence of systemic infection<ref>Fahimi J, Singh A, Frazee BW. The role of adjunctive antibiotics in the treatment of skin and soft tissue abscesses: a systematic review and meta-analysis. CJEM. 2015 Feb 20:1-13.</ref>; for immunosuppressed patients; or [[abscess]] that does not respond to standard treatment <ref>Singer A, Talan D. Management of Skin Abscesses in the Era of Methicillin-Resistant Staphylococcus aureus. N Engl J Med 2014; 370:1039-1047</ref>		**Previously [[antibiotics]] were indicated only for 1) overlying cellulitis; 2) evidence of systemic infection<ref>Fahimi J, Singh A, Frazee BW. The role of adjunctive antibiotics in the treatment of skin and soft tissue abscesses: a systematic review and meta-analysis. CJEM. 2015 Feb 20:1-13.</ref>; for immunosuppressed patients; or [[abscess]] that does not respond to standard treatment <ref>Singer A, Talan D. Management of Skin Abscesses in the Era of Methicillin-Resistant Staphylococcus aureus. N Engl J Med 2014; 370:1039-1047</ref>

Rossdonaldson1: /* See Also */

2021-02-18T17:27:58Z

Elcatracho: /* See Also */

2021-01-18T20:59:15Z

Rossdonaldson1: /* See Also */

2020-04-29T20:34:54Z

← Older revision		Revision as of 17:27, 18 February 2021
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	*[[EBQ:Irrigation of Cutaneous Abscesses Does Not Improve Treatment Success]]		*[[EBQ:Irrigation of Cutaneous Abscesses Does Not Improve Treatment Success]]
	*[[Procedure sample documentation]]		*[[Procedure sample documentation]]

			==External Links==

			===Videos===
			*ERCast Loop Abscess Drainage (6:58) https://vimeo.com/19580472
			*NEJM (10:12) https://www.youtube.com/watch?v=MwgNdrA18fM&feature=emb_logo

	==References==		==References==

← Older revision		Revision as of 20:59, 18 January 2021
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	*[[Bartholin Gland Abscess]]		*[[Bartholin Gland Abscess]]
	*[[EBQ:Irrigation of Cutaneous Abscesses Does Not Improve Treatment Success]]		*[[EBQ:Irrigation of Cutaneous Abscesses Does Not Improve Treatment Success]]
			*[[Procedure sample documentation]]

	==References==		==References==

← Older revision		Revision as of 20:34, 29 April 2020
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	==See Also==		==See Also==
			*[[Abscess]]
	*[[Lidocaine]]		*[[Lidocaine]]
	*[[Bartholin Gland Abscess]]		*[[Bartholin Gland Abscess]]