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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
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Aspiration of abscess

ABSCESS DRAINAGE

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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

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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
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  • 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
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  • Treat paronychia with incision over involved area (A), or incise a portion of the nail for effective pus drainage (B)
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  • Treat fingertip abscesses with a "hockey stick" incision (C)
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