Trick of the Trade: High volume irrigation of abscesses

Posted by Michelle Lin, MD on

Large-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.

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.

Author information

ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco

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