Incision and drainage: Difference between revisions
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#May use US or needle aspiration | #May use US or needle aspiration | ||
#Check: Blood Glucose, IV drug use (XR r/o needle), consider HIV counseling/testing | #Check: Blood Glucose, IV drug use (XR r/o needle), consider HIV counseling/testing | ||
==Differential Diagnosis== | |||
{{Template:SSTI DDX}} | |||
==Treatment== | ==Treatment== | ||
#Antibiotics | #[[Antibiotics]] | ||
##Give if there is a large cellulitic component or fever | ##Give if there is a large cellulitic component or [[fever]] | ||
##Need to cover staph and strep | ##Need to cover [[staph]] and [[strep]] | ||
#Update Tetanus | #Update [[Tetanus]] | ||
===Incision & Drainage=== | ===Incision & Drainage=== | ||
#Be sure to document if packing was placed in the wound | #Be sure to document if packing was placed in the wound | ||
#Anesthesia should be lidocaine or Marcaine without epinephrine | #Anesthesia should be [[lidocaine]] or Marcaine without epinephrine | ||
#Most patients need some pain medicine prior to procedure | #Most patients need some pain medicine prior to procedure | ||
Revision as of 04:20, 28 April 2014
Background
Diagnosis
- May use US or needle aspiration
- Check: Blood Glucose, IV drug use (XR r/o needle), consider HIV counseling/testing
Differential Diagnosis
Skin and Soft Tissue Infection
- Cellulitis
- Erysipelas
- Lymphangitis
- Folliculitis
- Hidradenitis suppurativa
- Skin abscess
- Necrotizing soft tissue infections
- Mycobacterium marinum
Look-A-Likes
- Sporotrichosis
- Osteomyelitis
- Deep venous thrombosis
- Pyomyositis
- Purple glove syndrome
- Tuberculosis (tuberculous inflammation of the skin)
Treatment
- Antibiotics
- Update Tetanus
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!!!
Follow-up
Wound check in 1-2 days and wound care sheet