g. Irrigation. The irrigation fluid of choice is normal saline since this fluid is
nonirritating to body tissue.
(1) Efficiency of irrigation. The efficiency of irrigation is directly related to
the force of the stream of the fluid used in irrigating and size of particles being removed.
Larger particles are more easily removed than smaller particles. High pressure
irrigation is more effective than low pressure irrigation.
(2) Methods of irrigation. There are three commonly used methods of
irrigating wounds: by bulb or asepto syringe, by 35cc syringe and a 19-gauge needle,
and by a mechanical jet device. Irrigation by a bulb or asepto syringe is a relatively low
pressure form of irrigation and is used for clean, uncontaminated wounds. Irrigation
using a 35cc syringe and a 19-gauge needle is the preferred method for irrigating
contaminated wounds and uses intermediate pressure. The fluid in a mechanical jet
device is under high pressure. Only normal saline or Ringer's solution should be used.
When using this device, be careful not to balloon the tissue by deep spreading fluid into
ABSCESS INCISION AND DRAINAGE
An abscess is an infection that results in a collection of purulent material in a
circumscribed and closed cavity. When an abscess is in the early stages of
development, it may be treated with warm compresses. If this treatment is
unsuccessful, incision and drainage (I & D) may need to be performed on a wound that
has abscessed. Incision and drainage is the release of the collection of pus by making
an incision in the skin and draining the pus. An I and D is commonly performed in a
clinic setting. Indication of the need for an I and D is an abscess that is localized,
erythematous, tender, and fluctuant.
a. General Considerations. There are few if any contraindications to the
procedure of abscess incision and drainage. Recurrent episodes of abscess may
indicate an underlying problem such as malnutrition, poor hygiene, diabetes, or immune
deficiencies. These are not considered contraindications. Additionally, follow these
Be sure sterile procedure is used to avoid secondary contamination.
Obtain informed consent before performing an incision and drainage
b. Equipment Needed. Gather the following equipment:
Sterile gloves, drapes, and surgical gowns.
(2) Antiseptic cleansing solutions such as povidone-iodine (Betadine) or