CCANTER
Networker
i know i would use drainage. But then wasnt sure if i use the anatomic location of rectum and then open? that doesnt seem right. I did find in the coding clinic for a perianal abscess used the location of the buttocks.
Abscess runs proximally along the right side of the rectum from the skin 9 cm and there is also a component of the abscess that runs transverse in the same area 9 cm anterior to posterior.
On exam the patient has a 2+ centimeter skin eruption draining purulence just to the right of the anus. This is just large enough for the surgeons index finger to probe and the wound probes straight proximally along the right side of the rectum and anteriorly. Bovie cautery was used to extend this spontaneous opening of the skin and the skin edges are attenuated and not viable anyway. The wound was then probed with an index finger to the full extent and progresses anteriorly. The wound proximally along the right side of the rectum measures 9 cm and also 9 cm in a transverse direction anterior to posterior. Given the extent of the wound anteriorly the where there is quite a bit of tunneling a window was opened up with the Bovie and the anterior extent of the wound. Now there are 2 incisions draining the abscess cavity. The wound is irrigated with some dilute Betadine solution and then Curlex is packed into the wound and removed in order to debride the exudate and loose slough of tissue lining the abscess cavity. Bovie was used for hemostasis at all incisions.
The wound is then packed with a dilute Betadine solution soaked Curlex proximally along the right side of the rectum and then also anteriorly. The wound is seen to be hemostatic.
Abscess runs proximally along the right side of the rectum from the skin 9 cm and there is also a component of the abscess that runs transverse in the same area 9 cm anterior to posterior.
On exam the patient has a 2+ centimeter skin eruption draining purulence just to the right of the anus. This is just large enough for the surgeons index finger to probe and the wound probes straight proximally along the right side of the rectum and anteriorly. Bovie cautery was used to extend this spontaneous opening of the skin and the skin edges are attenuated and not viable anyway. The wound was then probed with an index finger to the full extent and progresses anteriorly. The wound proximally along the right side of the rectum measures 9 cm and also 9 cm in a transverse direction anterior to posterior. Given the extent of the wound anteriorly the where there is quite a bit of tunneling a window was opened up with the Bovie and the anterior extent of the wound. Now there are 2 incisions draining the abscess cavity. The wound is irrigated with some dilute Betadine solution and then Curlex is packed into the wound and removed in order to debride the exudate and loose slough of tissue lining the abscess cavity. Bovie was used for hemostasis at all incisions.
The wound is then packed with a dilute Betadine solution soaked Curlex proximally along the right side of the rectum and then also anteriorly. The wound is seen to be hemostatic.