Know various steps to preforming and Incision and Draining of an abscess
Use a # 11 scalpel
- open (cruciate or linear)
- let contents drain then gently express
- break up inside with hemostat or blunt object
- pack cavity with iodine impregnated guause or put a drain in
- dress wound
- change dressing daily
- 3 days chaning drain remove puss
pitfalls of attempting to dran abscess before it has formed
- increased bleeding without drainage
- increased potential for infection
why use cruciate incision
- helps prevent premature wound closure during drainage and healing
- the linear incision has less scarring
what does it mean to advance the drain
patient can pull out an inch of drain each day trim off excess and rebandage eacj dau/
configuration of elipse
3 long; 1 wide with 30degree angles at ends
why cut skin perpendicular for ellipse
allows for better eversion on closure
options for wound dehisces
Partial: one or more sutures open
- watch for infection, debride, clean, bandage, let heal by secondary intention
Complete : open wound
- debride clean, resuture if no suture and less than 24 hours passed.
two option of anesthesia for nail removal
- Digital block - No epi
- 27 gague needle ,
- 1% lidocanes
Crush injuries: used .25%bupivacaine for lidocaner or mix 50:50
two resions for three point corner stitch
for lacerations and more advancedspediality and plastic surgery
scalpel for shave biopsy
15 blade
