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Incision and Drainage
Abscess incision and drainage is a very simple procedure that should be in every primary care physician’s arsenal.
Most textbooks such as Pfenninger and Fowler’s Procedures for Primary Care teach this skill.
Historically, I&D was performed by cleaning the skin of an abscess with betadine, puncturing the skin with a #11 scalpel blade, evacuating/cleaning the cavity (including breaking down the loculations), and then packing the wound with strip gauze (if you’re not familiar with strip gauze, it looks like a long shoestring made of gauze). The packing would be (painfully) removed and replaced every 2 days until the wound had granulated in.
In more recent years, an I&D technique known as “vessel loop drainage” has emerged that is widely considered the superior treatment option. This technique uses drainage but no packing, which eliminates the need for repetitive and painful packing replacement. (Alliteration intended.) This technique has superior healing times, infection rates, less scarring, and higher patient satisfaction. A video demonstrating this technique is linked below.
The physician only needs betadine, saline, a #11 scalpel, a silicone vessel loop, a curved hemostat, a cotton-tipped applicator, and gauze sponges to perform this procedure. These supplies cost less than $4 total.
https://vimeo.com/19580472
* This video is provided solely as an educational reference for DPC Alliance members.
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Incision and Drainage
Abscess incision and drainage is a very simple procedure that should be in every primary care physician’s arsenal.
Most textbooks such as Pfenninger and Fowler’s Procedures for Primary Care teach this skill.
Historically, I&D was performed by cleaning the skin of an abscess with betadine, puncturing the skin with a #11 scalpel blade, evacuating/cleaning the cavity (including breaking down the loculations), and then packing the wound with strip gauze (if you’re not familiar with strip gauze, it looks like a long shoestring made of gauze). The packing would be (painfully) removed and replaced every 2 days until the wound had granulated in.
In more recent years, an I&D technique known as “vessel loop drainage” has emerged that is widely considered the superior treatment option. This technique uses drainage but no packing, which eliminates the need for repetitive and painful packing replacement. (Alliteration intended.) This technique has superior healing times, infection rates, less scarring, and higher patient satisfaction. A video demonstrating this technique is linked below.
The physician only needs betadine, saline, a #11 scalpel, a silicone vessel loop, a curved hemostat, a cotton-tipped applicator, and gauze sponges to perform this procedure. These supplies cost less than $4 total.
https://vimeo.com/19580472
* This video is provided solely as an educational reference for DPC Alliance members.