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Incision and drainage or wide excision?
For removal of pus from abscess on neck skin through surgery, which one method is best and highly recommended? Incision and drainage or wide local excision in terms of cost, pain, healing, infection, recurrence etc??? for both the procedures, what's the appx cost in general??? after the surgery, any chance of recurrence of the same in future??? attached herewith the photo of the infected area. Thanks a lot for your valuable suggestions
Answers (4)
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Based on the history and clinical picture, it seems to be either Acute Lymphadenitis or Abscess. Tubercular origin is less likely if the duration of symptoms is acute.
Next Steps
1) Kindly undergo Ultrasonography of Neck to confirm the diagnosis.
2) If it comes out to be Lymphadenitis, look for any flu symptoms like cough, cold or fever & take an antibiotic course.
3) If it comes out to be abscess, undergo Incision & Drainage. And send the pus for AFB, culture & Sensitivity and treat with appropriate antibiotics accordingly
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The abscess seems to be cold abscess due to tuberculosis
Sputum examination and pus culture and sensitivity has to be done to rule out kochs etiology
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If the diagnosis is acute abscess, then one would do incision and drainage. The doctor need to send pus for culture and sensitivity and prescribe antibiotics accordingly.
In India such abscess can be due Tuberculosis of neck lymph nodes. The abscess could be long standing. Non dependant aspiration is done to prevent sinus formation.
Sometimes, the Tuberculous abscess can be excised with underlying lymph nodes. Pus is sent for culture and excised tissue is sent for histopathological examination to rule out tuberculosis.
Next Steps
It is advisable to consult a surgeon and get investigated for cause of abscess.
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Dr. Aditya Prasad Padhy
Urologist
11 yrs exp
Bhubaneswar
First of all for abscess i&d usually done. Excision may require depend upon the cause for the abscess
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.