腮腺导管脓肿切排.pdfVIP

Incision and Drainage of Parotid Duct 61 Abscess Melinda W. Fernandez and Bobby K. Desai 61.1 Indications 61.3 Materials and Medications (Fig. 61.1 ) • Parotid duct abscess • #11 scalpel • 4 × 4 gauze • Hemostat 61.2 Contraindications • Penrose drain or ¼-inch packing gauze • Light source (headlamp or overhead light) • Absolute • Culture swab – None • 4-0 silk suture • Relative • 25- to 27-gauge needle, 1.5–2 inches long – Pediatric patient • 18-gauge needle to withdraw anesthetic from vial – Severe trismus—may need sedation or drainage in the • 5-mL syringe operating room • Viscous lidocaine or other topical anesthetic – Uncooperative patient—may need sedation or drain- • Lidocaine with epinephrine age in the operating room • Suction setup with Frazier or tonsil suction tip – Coagulopathy, patients taking anticoagulants, or patients with a known bleeding disorder M.W. Fernandez, MD Department of Emergency Medicine , University of Florida Health , Gainesville , FL , USA e-mail: mindyfe