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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.
The purpose of a drain is to prevent fluid (blood or other) build-up in a closed ("dead") space, [2] which may cause either disruption of the wound and the healing process or become an infected abscess, with either scenario possibly requiring a formal drainage/repair procedure (and possibly another trip to the operating room).
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.
Harry Hancock performed the first abdominal surgery for appendicitis in 1848, but he did not remove the appendix. [27] In 1889 in New York City, Charles McBurney described the presentation and pathogenesis of appendicitis accurately and developed the teaching that an early appendectomy was the best treatment to avoid perforation and peritonitis .
Pancreatic abscess is a late complication of acute necrotizing pancreatitis, occurring more than 4 weeks after the initial attack. A pancreatic abscess is a collection of pus resulting from tissue necrosis, liquefaction, and infection. It is estimated that approximately 3% of the patients with acute pancreatitis will develop an abscess. [1]
Treatment is with antibiotics and drainage of the abscess; typically guided by ultrasound or CT, through the skin, via the rectum, or transvaginal routes. [3] Occasionally antibiotics may be used without surgery; if the abscess is at a very stage and small. [2] Until sensitivities are received, a broad spectrum antibiotic is generally required. [2]
This may mimic acute appendicitis or form a pelvic abscess. The left paracolic gutter is larger than the right, which together with the partial barrier provided by the phrenicocolic ligament (also known as Hensing's ligament), may explain why left subphrenic collections are more common than right subphrenic collections.
In case of complicated appendicitis managed by an emergency open appendectomy, abdominal drainage (a temporary tube from the abdomen to the outside to avoid abscess formation) may be inserted, but this may increase the hospital stay. [95] [needs update] The surgeon will start closing the incision.