TRIPASS XR تري باس

 

7. If indicated, insert plain, 0.5-inch gauze into abscess

cavity to stop bleeding and/or to serve as a wick to promote drainage (Fig. 48.2B).

8. Apply dry, sterile dressing.

9. Remove half of gauze packing in 24 hours and remainder within 48 hours. (Some larger wounds may require

multiple packing changes.)

10. Check abscess wound, and apply sterile warm soaks for

20 to 30 minutes, three times a day, until healing has

commenced, as indicated by

a. Cessation of drainage

b. Formation of granulation tissue

c. Resolution of local tissue inflammation

A B

Fig. 48.2. Drainage of a superficial abscess. A: Breaking the

septa with a clamp. B: Packing the wound.

Fig. 48.1. Superficial abscess in the site of a Broviac central

venous line insertion in the left anterior chest wall.

356 Section IX ■ Miscellaneous Procedures

G. Complications

1. Introduction of infection into sterile abscess or hematoma

2. Local bleeding

3. Injury to blood vessels, nerves, or tendons (deep to

abscess cavity) (5)

4. Incomplete drainage with recurrent abscess formation

(1,3)

5. Systemic infection (21,22)

6. Scar formation at drainage site, requiring skin graft (23)

7. Reduction of breast size following incomplete drainage

of breast abscess (24)

References

1. Meislin HW, Lerner SA, Graves MH, et al. Cutaneous abscesses.

Anaerobic and aerobic bacteriology and outpatient management.

Ann Intern Med. 1977;87:145.

2. Meislin HW, McGehee MD, Rosen P. Management and microbiology of cutaneous abscesses. JACEP. 1978;7:186.

3. Macfie J, Harvey J. The treatment of acute superficial abscesses: a

prospective clinical trial. Br J Surg.1977;64:264.

4. Butler KH. Incision and drainage. In: Roberts JR, Hedges JR, eds.

Clinical Procedures in Emergency Medicine. 4th ed. Philadelphia:

WB Saunders; 2004:717.

5. Albom MJ. Surgical gems. Surgical management of a superficial

cutaneous abscess. J Dermatol Surg. 1976;2:120.

6. Brook I. Microbiology and management of human and animal

bite wound infections. Prim Care.2003;30:25.

7. Folz BJ, Lippert BM, Kuelkens C, et al. Hazards of piercing and

facial body art: a report of three patients and literature review. Ann

Plast Surg. 2000;45:374.

8. Duong M, Markwell S, Peter J, et al. Randomized, controlled trial

of antibiotics in the management of community-acquired skin

abscesses in the pediatric patient. Ann Emerg Med. 2010;55:401.

9. Lee MC, Rios AM, Aten MF, et al. Management and outcome of

children with skin and soft tissue abscesses caused by communityacquired methicillin-resistant Staphylococcus aureus. Pediatr Infect

Dis J. 2004;23:123.

10. Llera JL, Levy RC. Treatment of cutaneous abscess: a doubleblind clinical study. Ann Emerg Med. 1985;14:15.

11. Rajendran PM, Young D, Maurer T, et al. Randomized, doubleblind, placebo-controlled trial of cephalexin for treatment of

uncomplicated skin abscesses in a population at risk for

community-acquired methicillin-resistant Staphylococcus aureus

infection. Antimicrob Agents Chemother. 2007;51:4044.

12. Zetola N, Francis JS, Nuermberger EL, et al. Communityacquired methicillin-resistant Staphylococcus aureus: an emerging threat. Lancet Infect Dis. 2005;5:275.

13. Halvorson GD, Halvorson JE, Iserson KV. Abscess incision and

drainage in the emergency department–Part I. J Emerg Med.

1985;3:227.