Clinical history is important for accurate diagnosis.
Treat via surgical drainage and lavage.
Antibiotics as indicated.
Consider bitewounds contaminated.
Failure of prompt response to treatment should warrant immediate attention.
MOST COMMON COMPLICATIONS AND DIFFICULTY
Failure to improve due to inadequate drainage or persistent presence of foreign body.
The drain is placed in a non-dependent location, not allowing for optimal function.
Dehiscence may occur in the presence of infection.
Abscess with proper drainage.
"EXPERTS' ADVICE"
If small, excise entirely, similar to a tumor.
Evaluate the patient in a standing position for the best drain location for dependent drainage. Mark the location while in a standing position and then be careful not to remove the mark during scrub preparation.
The infected wound is subject to further dehisence due to delayed healing and more rapid tensile strength loss of suture materials which are broken down by phagocytosis. Chromic gut should be avoided in these instances and monofilament suture with prolonged tensile strength is desirable. Adequate wound debridement and establishment of wound drainage using either passive latex tubes or active suction systems is encouraged.
opinion_lab.tpl
