Abscess is the focus of infection that occurs when the body tries to limit the inflammatory situation caused by microorganisms in any organ or tissue. It is often accompanied by symptoms such as fever, pain and redness, which vary depending on the size of the abscess. The naming of abscesses may vary depending on the location. Intensive antibiotic treatment is the first form of treatment that must be applied in the treatment of abscesses.
However, the use of antibiotics alone may be insufficient in the treatment of abscesses. Especially in abscesses located in deep tissues (for example, between the abdominal membranes, liver, kidney, lung, etc.), this inflammatory focus must be removed by an interventional procedure.
These interventional procedures;
1.Surgical
2. Percutaneous abscess drainage
Surgical Abscess Drainage
It is the process of removing the focus in the area where the abscess develops with surgery. After the pain is relieved with local anesthesia, general anesthesia or spinal-epidural anesthesia depending on the area where the abscess develops, the inflamed area is surgically removed while the patient is under sterile conditions. If necessary, plastic tubes called catheters are placed in this area, with one end remaining outside the body and the other end remaining in the surgery area, to ensure that the inflamed area drains out after the surgery. Antibiotic use should be continued in the postoperative period, as in the preoperative period.
Percutaneous Abscess Drainage
It is one of the treatment methods frequently applied by Interventional Radiologists. The most commonly applied areas are intra-abdominal abscesses, lung abscesses, and abscesses seen in the limbs. Intra-abdominal abscesses can occur in the peritoneal cavity, as well as in organs such as the liver, kidney and spleen.
No surgical procedure is performed for percutaneous abscess drainage. The procedure can be performed in the interventional radiology room, angiography rooms, examination rooms or, if the environment is not suitable, in the operating room. Local anesthesia is applied for the drainage process. This procedure consists of numbing the area where the procedure will be performed with small needles. Then, the area to be drained from the abscess is sterile, just like in the surgery. It is covered with covers, and the area to be discharged is cleaned with liquids that will provide sterilization. Then, the abscess is reached with the help of some needles used in interventional radiology, and a plastic tube called a catheter is placed in this area for drainage. One end of this tube should be placed inside the abscess and the other end outside the body. After the tube is placed, it is fixed to the skin in some cases to prevent it from coming out or getting caught on clothes.
After the abscess is drained, the patient continues to use antibiotics for a while. In this way, the recurrence of the abscess is prevented or, if some of the inflamed tissue remains inside, the remaining inflammation is eliminated.
Depending on the response of the person to whom the abscess drainage tube (catheter) is placed, the tube is left inside for a while. This time is adjusted according to the person's clinical condition or the amount of inflammation flowing through the catheter on a daily basis. Frequently, the tube is not removed until the inflammation decreases to 10 cc per day from the inserted catheter. The tube can be removed after the inflammation is seen to be over with diagnostic tools such as ultrasonography, computed tomography or, if necessary, MRI. After the tube is removed, the skin entrance of the tube may be dressed for a while. Usually there is no need to put any stitches in this area. However, in cases where a thick tube is placed, stitches may be required if there is an opening of 1-2 cm on the skin.
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