Todays pearl was inspired by the amazing and innovative Dr. Vella and Dr. McVane.

 

We all have had the joy of draining a large pilonidal abscess.  You know the second that abscess opens white pus will flow freely creating mountains of dirty 4x4s and an aroma that may inspire you to vomit.  But what if there was a better way?  Perhaps there is….

The novel idea is to use suction to aid in the drainage of that large abscess.  Dr. Vella and Dr. McVane performed this procedure recently and is described below:

  1. A fine needle was inserted into the abscess and 5-10 cc’s of pus was withdrawn.  The syringe was then changed and a second lidocaine filled syringe was directly injected into the abscess pocket.
  2. The needle was removed and a small approx 1-1.5 cm incision was made.
  3. They then used a Flexible Yankauer (see picture below) attached to suction and inserted this directly into the abscess pocket which allowed them to directly aspirate pus from the cavity

suction

4.  After the pus was removed via suction the Yankauer tip was then used to manually break up loculations in the abscess cavity.

 

Per Dr. McVane the room smelled great, there was no mess to be seen and the patient tolerated the procedure well.  This probably would not be useful if the abscess is small but certainly has many upsides with large abscessi.