TECHNIQUE
■ Ultrasound may be used to guide incision or needle aspiration.
■ Regional blocks are preferred to local anesthesia as local anesthetic agents
function poorly in the low pH of infected tissue and local injection is
painful. Conscious sedation may be appropriate.
■ Patients at risk for endocarditis should receive IV antibiotics prior to I+D.
■ Abscess is incised along total length of the cavity for noncosmetic areas.
For cosmetic areas a stab incision or simple aspiration may be attempted.
■ The abscess should be probed to break open loculations with hemostat or
hemostat wrapped in gauze.
■ Irrigate and gently pack cavity with gauze.
■ Prescribe packing change periodically and follow up in 1–3 days.
■ The use of antibiotics following I+D is a clinical decision that depends on
host factors (immunocompromised status, diabetes) and wound character-
istics (associated cellulitis).
COMPLICATIONS
■ Bleeding
■ Extension of infection
■ Recurrence
INTERPRETATION OFRESULTS
■ Drainage of pus indicates correct localization of pus but follow-up must be
provided to ensure progression of adequate drainage.
PROCEDURES AND SKILLS