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Flashcards in Incision and Drainage Deck (5)
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1

Folliculitis:
-what is this?
-tx
-MC cause of hot tub folliculitis?

What: superficial infection of hair follicles in the epidermis

Tx: resolve spontaneously, warm compress may help

MC cause hot tub = pseudomonas aeruginosa

2

What is the difference between:
-skin abscess
-furunlce
-carbuncle

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

Indications for I&D

CI/Concerns for I&D

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

Risk factors for Abscess

What are some preprocedure medical issues you should address?

DM, immunological abnormalities, breaches of skin barrier.

Medical issues:
- lidocaine allergy (may use injectable benadryl)
- heart valve or total joint, need abx prophylaxis

5

When to consider abx therapy after abscess drainage?

Which abx would you prescribe?

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