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Incision and Drainage

Incision and Drainage. Bucky Boaz, ARNP-C. Abscess Etiology. Staphylococcal strains Group A B -hemolytic streptoccal Anaerobic bacterial. HOSTS MANUAL LABOR WOMEN IV DRUG USERS. HIGH CONCEN. OCCLUDE. INTACT SKIN. MOIST ENV. TRAUMA. NUTRIENTS. LIQUIFY & ACCUM. LOCULATION

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Incision and Drainage

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  1. Incision and Drainage Bucky Boaz, ARNP-C

  2. Abscess Etiology • Staphylococcal strains • Group A B-hemolytic streptoccal • Anaerobic bacterial

  3. HOSTS MANUAL LABOR WOMEN IV DRUG USERS HIGH CONCEN. OCCLUDE INTACT SKIN MOIST ENV. TRAUMA NUTRIENTS LIQUIFY & ACCUM LOCULATION OF PUS CELLULITIS NECROSIS Pathogenesis ABSCESS

  4. Bacteriology of Cutaneous Abscesses • Head, neck, extremities, trunk • Staphlocci • Group a B-hemolytic streptococci • Buttocks and perirectal • Anaerobes • Perirectal area, head, fingers, and nailbed • Mixed aerobic and anerobic

  5. Special Considerations • Parental drug users • Insulin-dependent diabetics • Hemodialysis patients • Cancer patients • Transplant recipients

  6. Laboratory Findings • Offer no specific guidelines for therapy • Not indicated • Gram stain not indicated • Routine culture not indicated • Except immunosuppressed

  7. Indications and Contraindications • Incision and drainage is definitive treatment • Antibiotics alone are ineffective • Premature incision • Heat • Nonsurgical recheck <24-36 hours

  8. Ancillary Antibiotic Therapy • Prophylactic Antibiotics • Endocarditis • Bacteremia in other conditions • Therapeutic Antibiotics

  9. Incision and Drainage Procedure • Procedure site • Equipment and Anesthesia • Incision • Wound Dissection • Wound Irrigation • Packing and Dressing

  10. Follow-up Care • Reevaluation 1-3 days (48 hours standard) • Closely follow • Immunosuppressed • Facial abscess • Instruct on wound care • Decide on repacking • Peroxide and Q-tips

  11. Specific Abscess Therapy • Staphyloccal Disease • Hidradenitis Suppurativa • Breast Abscess • Bartholin Gland Abscess • Pilonidal Abscess • Infected Sebaceous Cyst

  12. Specific Abscess Therapy • Perirectal Abscess • Pathophysiology • Epidemiology • Physical and laboratory findings • treatment

  13. Questions?

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