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CELLULITIS AND ABSCESS:Technique
Infiltrate uninfected tissue surrounding the abscess with a local anesthetic
If in doubt about diagnosis, perform preliminary aspiration using 18 gauge or larger needle
Make an incision over the most prominent part of the abscess or guided by findings on needle aspiration
Aspiration of abscess
ABSCESS DRAINAGE
Introduce tip of artery forceps into cavity, open jaws
Explore cavity with finger to break down all septae
Extend incision, if necessary, for complete drainage
CELLULITIS AND ABSCESS: Breast
CELLULITIS AND ABSCESS: Hand
Staphylococci most common organism
Patients present with throbbing pain, warm, tender swelling, pain on movement
May attempt antibiotics alone.
Confirm the abscess with needle aspiration, send pus for Gram stain
Swelling on the dorsum of the hand often caused by lymphedema, does not require drainage
Make adequate, but not extensive incision along skin crease at site of maximum swelling (figure)
Aspirate, irrigate all pus
Open up deeper loculi with artery forceps
Insert drain
Dress wound loosely with dry gauze
Administer antibiotics
Keep hand elevated
Treat paronychia with incision over involved area (A), or incise a portion of the nail for effective pus drainage (B)
Treat fingertip abscesses with a "hockey stick" incision (C)