Hepatectomy For Pyogenic Liver Abscess

Write brief notes on incision and drainage.

Answer. Incision and drainage is the surgical procedure carried out to relieve the pus.

Mainly incision and drainage is done in pyogenic abscess.
Incision and drainage is contraindicated in cold abscess.
During incision and drainage position ofthe patient should be supine, prone or lateral depending upon the site of abscess.

“Importance Of Hepatectomy In Treating Pyogenic Liver Abscess”

Incision and drainage procedure

For this procedure, preferred anesthesia is general anesthesia because abscess is multiloculated and infiltration of lignocaine into the abscess cavity does not act because of the acidic pH of the pus.
However, a superfiial abscess which is pointing can be managed without general anesthesia.
Provide a stab incision over the most prominent part of the swelling, i.e. part which is red, skin is thinned out over it and is pointed.
As incision is given and pus comes out of the swelling, it should be sent for culture and sensitivity.
A sinus forceps or figer is now introduced inside the abscess cavity and all the loculi present inside the cavity should be broken.
As fresh blood oozes out, this indicates the completion of the procedure.

“Risk Factors For Requiring Hepatectomy In Liver Abscess Patients”

Cavity should be irrigated with hydrogen peroxide solution or iodine solution.
If size of the cavity is large, it should be packed by roller gauze which is soaked in iodine and it is removed after 24 to 48 hours.
Packing helps in controlling the bleeding and due to the pack, the opening of abscess cavity does not close.
By 7 to 10 days, the cavity collapses spontaneously and granulation tissue fils up the cavity and healing takes place.
An abscess should not be closed, as it contains bacteria, etc. It should be drained out.

“Understanding The Role Of Hepatectomy In Treating Pyogenic Liver Abscess”

Incision and drainage Postoperative Management

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