Incision and drainage of iliac fossa abscess

The armpit is located on both sides of the pelvis, between the posterior peritoneum and the iliac crest muscle. It is a loose connective tissue gap with external iliac veins, veins, spermatic cord (or ovary), veins, axillary lymph nodes, and reproductive tracts. Nervous and ureteral, etc., when the infection forms an abscess that requires incision, attention must be paid to local anatomy. Treatment of diseases: lymphatic tuberculosis Indication Once the axillary abscess is formed, the drainage should be cut open. Preoperative preparation 1. Surgical history and physical examination should be carefully asked before surgery, and puncture should be differentiated from appendix abscess, lumbar tuberculosis cold abscess, sacral osteomyelitis and acute suppurative hip arthritis. 2. Rational use of antibiotics. 3. Pay attention to supportive therapies such as blood transfusion, infusion, correction of anemia and imbalance of water and electrolyte balance. Surgical procedure 1. Incision: about 2 cm inside the anterior superior iliac spine, and about 4 cm along the upper edge of the inguinal ligament, and a 4-5 cm long oblique incision. 2. Cut the skin, subcutaneous tissue and extra-abdominal oblique aponeurosis, reveal the intra-abdominal oblique muscles, cut the fascia along the direction of the muscle fibers, and bluntly separate the intra-abdominal oblique muscles and the transverse abdominis muscle fibers to reveal the peritoneum. 3. Push open the peritoneum: Use the finger wrapped around the wet gauze to push the peritoneum upwards to reveal the axillary fossa. It can be seen that the axillary abscess is convex forward. 4. Cut the abscess: puncture the pus with a coarse puncture needle to determine the thickness of the abscess wall, and leave the needle as an indication of the abscess. Use a knife to cut a small opening in the wall of the abscess, then use a hemostatic forceps to divide into the abscess and use the aspirator to absorb the pus. 5. Set the drainage strip: according to the size of the abscess, expand the abscess wall incision for smooth drainage. Then place two cigarettes in the abscess (or rubber tube drainage). The outer end of the drainage tube is pierced with a pin to prevent slipping into the abscess. If there is more bleeding, the vaseline gauze can be used to block the pus to stop bleeding, and the other end of the gauze remains outside the body. The slit is finally sutured layer by layer. Do not suture too tightly at the drainage to avoid obstructing drainage.