Fig. 165.1 (A) Large pustule before débridement. Local anesthesia is not required. (B) Pustule after débridement and cleansing.

Fig. 165.2 Anesthetizing the incision site of a small abscess. The anesthetic is injected in the subcutaneous plane under the area of the planned incision.

Fig. 165.3 Loop drainage technique. (A) Step 1: Prepare the area and administer local anesthesia. Make a central incision and use a hemostat to break up loculations within the abscess. The abscess may be irrigated now or after the vessel loop is placed. (B) Step 2: Use the hemostat to tent the skin near the farthest edge of the abscess cavity, and make a second incision over the tip of the hemostat. (C) Step 3: Once the second incision is made, push the hemostat through the new incision, and use it to grab the vessel loop and pull it through the abscess cavity. (D) Step 4: Pull vessel loop through the abscess cavity. (E) Step 5: Tie the vessel loop, using a finger or hemostat to keep it loose over the surface of the skin. (F) Step 6: Appearance of final vessel loop placement.

Fig. 165.4 Abscess drainage procedure. NS, Normal saline.

Fig. 165.5 Folliculitis.

Fig. 165.6 Furuncle.

Fig. 165.7 Carbuncle.