"Initially about a 3 cm incision was made centered over the fluctuant area anterior shoulder there was significant pressure and frank purulent material which was extruded. Deep cultures were obtained. This was evacuated there was a large about 12 to 15 cm abscess with pseudocapsule in the subcutaneous superficial to the deltoid this was curetted to remove pseudocapsule and copious irrigated. Utilizing Metzenbaums a small deltoid split into the joint was carried out anteriorly and a second purulent fluid collection was encountered. The deltoid was split in line with the fibers in order to debride and irrigate the joint. We were able to curette the bony surfaces and copious irrigated with pulsatile lavage."