Why pack abscess

The packing material should be wet, but not dripping. Gently put the packing material into the wound. Packing should fill the wound space completely, but not tightly. Use a cotton swab to gently guide the packing into small or tunneled areas. Open your outer dressing material and place it on the towel. Make a follow-up appointment. It is recommended that you be seen within 48 hours after the first time a packing is placed. Discharge Instructions: Packing a Wound You will need to care for a special dressing, or packing, in your wound.

Gather your supplies Keep your supplies all in 1 place. You will need the following: Packing material Sterile wetting solution Sterile gloves A clean bowl Scissors A clean towel A bandage to put on the top of the wound after you have packed it Tape Cotton swabs A small plastic bag Clean up Clean the area where you will set out your dressing supplies. Having patients return for packing removal can cost them both time and money as they will often have to take off from work to either follow-up in the ED or with their primary-care provider.

As the evidence against packing starts to stack up, I find myself using packing less and less in my practice. I still pack abscesses, but not nearly as frequently as I did when I first started in the ED. Now, I will only pack under certain circumstances. If the abscess is particularly deep, I will pack, often using iodoform if I think the wound will need the assistance of an antiseptic agent. I will also pack if there is a lot of surrounding induration, because there is a good chance the wound will have more purulence in the days to come and need the wicking capabilities of packing.

I will also pack if I want the patient to come back so that the wound can be looked at in the next couple of days. If the patient appears as though they may not be particularly hygienic, not very dedicated to following their discharge instructions, and apt not to come in until they have a raging infection, then I will pack. Funny how that works. However, the patient complains of pain when you begin to pack it with iodoform gauze. He asks if packing is really necessary.

Is it? The Choices: 1. More pain med. Inform the patient that packing really does make a difference in preventing abscess reformation. No pain med. Pack faster and distract the patient with your sense of humor. Remove the packing and send the patient home with close follow-up. Wing it. Replace the iodoform gauze with sterile packing strips and continue packing. In , U. Abscess numbers are increasing far faster than the total number of ED visits, which increased from to million during the same interval.

In fact, at least seven prior controlled studies suggest that packing prolongs wound healing times without decreasing abscess recurrence rates Table 1. Caveats: Each of these trials is under-powered with incomplete blinding or randomization schemes and most compare suturing the abscess cavity closed compared with packing. The largest proportions of subjects in these prior trials were ED patients with superficial cutaneous abscesses, but others involved perianal abscess management by surgical consultants in non-ED settings.

Dating back to , a substantial number of observational trials have similarly suggested that mixed abscesses heal just as well with primary closure sutured obliteration of the abscess cavity as they do with traditional packing. The insufficient evidence to support packing aside, there are multiple reasons to consider not packing wounds.

The patients were largely African Americans with no differences in age or sex between the groups. Two-thirds of the patients were evaluated at hours. Twenty-one patients were from the PK group and 13 were from the NP group. Want to know more about abscesses? Tags: Uncategorized. I had the iodoform packing and it came out three incisions in my left arm what should i do to care for the wound after gauze has come out?

The wound is deep should i still bandage it after soaking in antibacterial soap? Jump to this post. Did it hurt when you had to pull out the packing? Should I do it myself like they said, or does it hurt to bad? Home Login Join. Make an appointment. Visit now. Explore now. Choose a degree. Get updates. Books and more Donate now. Toggle navigation.