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I&D - irrigation and debridement vs incision and drainage - sm

Posted: Feb 09, 2010

Is there any clear way to know how I&D should be expanded?  Am I correct to assume irrigation and debridement for a wound and incision and drainage for an abscess?

What about for a paronychia?  Right now I have a patient who was I&D'd recently for a paronychia, which is an abscess, so I assume it was incised and drained, but it also says the nail was debrided.

I&D - MT

[ In Reply To ..]
I don't assume anything, but if there is an abcess it is probably incision and drainage and I feel safe with that. Other than that, I just follow rules for what to do if we have to expand and we aren't sure.

I leave it if I'm not sure, I was just hoping there was... - sm

[ In Reply To ..]
a way to be sure, so I can avoid having a sloppy "I&D'd" in my report, especially in the diagnosis.

I&D - MT

[ In Reply To ..]
Oh, I know how you feel, but it's way better than accidentally choosing the wrong one. It would go from an oopsie on an audit to a YIKES if you happened to expand it wrong. My personal jury is still out on the actual wound and if it would get incised. I'm not thinking they would have to incise it, but maybe they would as an infection precaution. We just don't know and we need to leave that up to the dictator. Heck, maybe they'll actually start expanding it so we know for sure.

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