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Flashcards in Incision and Drainage Deck (5)
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1
Q

Folliculitis:

  • what is this?
  • tx
  • MC cause of hot tub folliculitis?
A

What: superficial infection of hair follicles in the epidermis

Tx: resolve spontaneously, warm compress may help

MC cause hot tub = pseudomonas aeruginosa

2
Q

What is the difference between:

  • skin abscess
  • furunlce
  • carbuncle
A

Skin abscess: collection of pus within the dermis and deeper skin tissues

Furuncle: infection of hair follicle, pus extends through dermis into sub Q tissue.

Carbuncle: multiple furuncles

3
Q

Indications for I&D

CI/Concerns for I&D

A

Most skin abscesses should undergo I&D.
–if draining spontaneoulsy may elect to follow.

CI/Concerns:

  • abscess location:
  • -perirectal area
  • -anterior and lateral neck
  • -breast near areola
  • -near vital nerves or blood vessels
  • -hand abscess (excluding paronchyia)
  • -central triangle of face
  • abscess types:
  • -recurrent or interconnected abscesses
  • -larger than 5cm
  • pt factors:
  • -airway issues
  • -bleeding disorder or anticoagulation

**in these circumstances you may need to refer to someone above your pay grade.

4
Q

Risk factors for Abscess

What are some preprocedure medical issues you should address?

A

DM, immunological abnormalities, breaches of skin barrier.

Medical issues:

  • lidocaine allergy (may use injectable benadryl)
  • heart valve or total joint, need abx prophylaxis
5
Q

When to consider abx therapy after abscess drainage?

Which abx would you prescribe?

A

if abscess greater than 5cm, extensive cellulitis, signs and sx of systemic infection, comorbidities, immunosuppression, prosthetic joints and valves.

Abx:

  • clindamycin, doxycycline, smx/tmp
  • -if SICK with suspected MRSA parenteral vancomycin.
  • dicloxacillin, keflex