Difference between revisions of "Incision and drainage"

(Updated format to procedure-centric)
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==Background==
 
*Check: Blood Glucose, IV drug use (XR r/o needle), consider HIV counseling/testing
 
 
 
==Indications==
 
==Indications==
  
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==Contraindications==
 
==Contraindications==
  
 +
 +
==Equipment Needed==
 +
 +
{{Maximum doses of anesthetic agents}}
  
 
==Procedure==
 
==Procedure==
  
===Anesthesia===
 
{{Maximum doses of anesthetic agents}}
 
  
===Post-procedure===
+
==Complications==
 +
 
 +
 
 +
==Follow-up==
 +
*Wound check in 1-2 days and wound care sheet
 
*[[Antibiotics]] only indicated if overlying cellulitis or evidence of systemic infection
 
*[[Antibiotics]] only indicated if overlying cellulitis or evidence of systemic infection
 
**Cover [[staph]] and [[strep]]
 
**Cover [[staph]] and [[strep]]
 
*Update [[Tetanus]], if indicated
 
*Update [[Tetanus]], if indicated
 
==Follow-up==
 
Wound check in 1-2 days and wound care sheet
 
  
 
==See Also==
 
==See Also==
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*Liu C, Bayer A, Cosgrove SE, et al. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. Clin Infect Dis 2011;52:e18-e55
 
*Liu C, Bayer A, Cosgrove SE, et al. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. Clin Infect Dis 2011;52:e18-e55
 
*Singer A, Talan D. Management of Skin Abscesses in the Era of Methicillin-Resistant Staphylococcus aureus. N Engl J Med 2014; 370:1039-1047
 
*Singer A, Talan D. Management of Skin Abscesses in the Era of Methicillin-Resistant Staphylococcus aureus. N Engl J Med 2014; 370:1039-1047
 
  
 
[[Category:Derm]]
 
[[Category:Derm]]
 
[[Category:ID]]  
 
[[Category:ID]]  
 
[[Category:Procedures]]
 
[[Category:Procedures]]

Revision as of 10:47, 21 June 2015

Indications

Contraindications

Equipment Needed

Maximum Doses of Anesthetic Agents

Agent Without Epinephrine With Epinephrine Duration Notes
Lidocaine 5 mg/kg (max 300mg) 7 mg/kg (max 500mg) 30-90 min
  • 1% soln contains 10 mg/ml
  • 2% soln contains 20 mg/ml
Mepivicaine 7 mg/kg 8 mg/kg
Bupivicaine 2.5 mg/kg (max 175mg) 3 mg/kg (max 225mg) 6-8 hr
  • 0.5% soln contains 5 mg/ml
  • May cause cardiac arrest if injected intravascularly
  • Do not buffer with bicarbonate
Ropivacaine 3 mg/kg
Prilocaine 6 mg/kg
Tetracaine 1 mg/kg 1.5 mg/kg 3hrs (10hrs with epi)
Procaine 7 mg/kg 10 mg/kg 30min (90min with epi)

Procedure

Complications

Follow-up

  • Wound check in 1-2 days and wound care sheet
  • Antibiotics only indicated if overlying cellulitis or evidence of systemic infection
  • Update Tetanus, if indicated

See Also

References

  • Liu C, Bayer A, Cosgrove SE, et al. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. Clin Infect Dis 2011;52:e18-e55
  • Singer A, Talan D. Management of Skin Abscesses in the Era of Methicillin-Resistant Staphylococcus aureus. N Engl J Med 2014; 370:1039-1047