AbscessLarge-sized abscess often have pus trapped in deep crevices and pockets. Irrigation can help express the pus. How can you set up a high-volume irrigation system?  

Trick of the Trade
Administer normal saline through a pressure IV bag and irrigate using an 18 gauge angiocatheter.
 

IrrigationHiPressure3sm  

Thanks to Dr. Julian Villar (EM resident at UCSF-SFGH) for the idea and action photo! Read his insightful comments in the Comments section.

Editorial comments 11/7/12:

  • Be aware that irrigation has not actually been shown to be necessary in incision and drainage procedures of abscess.
  • Be sure that there is a large exit hole for the high-pressure irrigation or else you will be injecting into a closed system, potentially dissecting through surrounding tissue planes.
Michelle Lin, MD
ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD

@M_Lin

Professor of Emerg Med at UCSF-Zuckerberg SF General. ALiEM Founder @aliemteam #PostitPearls at https://t.co/50EapJORCa Bio: https://t.co/7v7cgJqNEn
Michelle Lin, MD