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Incision and drainage (I&D), also known as clinical lancing, are minor surgical procedures to release pus or pressure built up under the skin, such as from an abscess, boil, or infected paranasal sinus.
Patients with odontogenic sinusitis may present with symptoms similar to those of other forms of sinusitis, such as nasal congestion, purulent nasal discharge, facial pain or pressure, and a reduced sense of smell. However, the presence of dental pain, foul smell, or a history of recent dental procedure might suggest an odontogenic source.
Mucopurulent discharge is the emission or secretion of fluid containing mucus and pus (muco-pertaining to mucus and purulent pertaining to pus) from the eye, nose, cervix, vagina or other part of the body due to infection and inflammation. Types include:
The surface may be shiny due to stretching of the mucosa over the abscess. Before pus has formed, the lesion will not be fluctuant, and there will be no purulent discharge. There may be regional lymphadenitis. When pus forms, the pressure increases, with increasing pain, until it spontaneously drains and relieves the pain.
Around 6% of infants have congenital nasolacrimal duct obstruction, or dacryostenosis, usually experiencing a persistent watery eye even when not crying. If a secondary infection occurs (dacryocystitis), purulent (yellow / green) discharge may be present. Most cases resolve spontaneously, with antibiotics reserved only if conjunctivitis occurs.
Depending on the amount of drainage, a patient may have the drain in place one day to weeks. Drains will have protective dressings that will need to be changed daily/as needed. The routine use of drains for surgical procedures is diminishing as better radiological investigation and confidence in surgical technique have reduced their necessity.
If the returning fluid is purulent, one repeats the puncture after a week. If more than three successive puncture shows returning fluid to be persistently purulent, the patient may require functional endoscopic sinus surgery (FESS) and occasionally may need Caldwell-Luc operation .
A dental abscess is a localized collection of pus associated with a tooth. The most common type of dental abscess is a periapical abscess , and the second most common is a periodontal abscess . In a periapical abscess, usually the origin is a bacterial infection that has accumulated in the soft, often dead, pulp of the tooth.