Say you've got a huge pus filled abscess that needs draining. Do you drain it, irrigate and pack it? Do you just pack, no irrigation? Or just irrigate and don't pack it. Mike and Sanjay discuss what to do.
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I use the loop abscess drainage method, and have had great results. Irrigation with saline and loculation breakup is part of my process. Nice to know that there's more than one way to skin this cat, but also nice to know that I'm not causing any harm too.
I have been rather dogmatic with fluctuant abscesses; incise, drain, pack. Love the loop drainage method.
However I get paralyzed with indecision about clinically non-fluctuant abscesses ( those abscesses you know you incise and nothing comes out). I tend to prescribe abx, and use a mupirocin/mag sulfate dressings until the abscess with gets better or it "matures" and become fluctant. Any other thoughts?
I also use the loop drainage method, and it works very well. In a couple of instances, nursing couldn't find a penrose drain or a vessel loop, so I threaded 1/4" packing through the holes and tied it in a bow to form a loop. It also works very well. Has anyone else tried this?
Great paper, Sanjay and Mike. Thanks for including it. As the author, I am was pleasantly surprised to hear you guys discussing it as I was driving home and realizing, that's my paper! It is not my normal practice to irrigate either, that's why I was interested in asking other providers about it. That'll be my next study….keep up the good work and thanks for all you do!
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Jose Diaz PA-C - March 1, 2014 12:17 PM
I use the loop abscess drainage method, and have had great results. Irrigation with saline and loculation breakup is part of my process. Nice to know that there's more than one way to skin this cat, but also nice to know that I'm not causing any harm too.
Paul T. MBChB - March 5, 2014 12:18 AM
I found this interesting.
I have been rather dogmatic with fluctuant abscesses; incise, drain, pack. Love the loop drainage method.
However I get paralyzed with indecision about clinically non-fluctuant abscesses ( those abscesses you know you incise and nothing comes out). I tend to prescribe abx, and use a mupirocin/mag sulfate dressings until the abscess with gets better or it "matures" and become fluctant. Any other thoughts?
Ron R. - March 8, 2014 4:16 AM
I also use the loop drainage method, and it works very well. In a couple of instances, nursing couldn't find a penrose drain or a vessel loop, so I threaded 1/4" packing through the holes and tied it in a bow to form a loop. It also works very well. Has anyone else tried this?
John L. - March 27, 2014 4:24 PM
I also have used it with great success. Patients hate having a drain for a week but love not having a huge incision.
Gillian S. - April 14, 2014 7:18 PM
Great paper, Sanjay and Mike. Thanks for including it. As the author, I am was pleasantly surprised to hear you guys discussing it as I was driving home and realizing, that's my paper! It is not my normal practice to irrigate either, that's why I was interested in asking other providers about it. That'll be my next study….keep up the good work and thanks for all you do!