Incision and drainage
Revision as of 16:22, 10 June 2014 by Silas Chiu (Added recommendations from Infectious disease Society of America and new NEJM article)
- May use US or needle aspiration
- Check: Blood Glucose, IV drug use (XR r/o needle), consider HIV counseling/testing
- Necrotizing soft tissue infections
- Mycobacterium marinum
- Update Tetanus
- MRSA decolonization for pts with recurrent skin infections
- Nasal mupirocin+chlorhexidine body wash+/-oral anti-MRSA abx for 5-10 days
Incision & Drainage
- Be sure to document if packing was placed in the wound
- Anesthesia should be lidocaine or Marcaine without epinephrine
- Most patients need some pain medicine prior to procedure
- Beware of toxic dose of lidocaine!
- Lido lasts 30-90 min, bupivicaine (.25%) max= 2mg/kg lasts 6-8 hr. Do NOT inject bupivicaine intravascularly b/c= refractory cardiac arrest!!!
Wound check in 1-2 days and wound care sheet