Boil (Skin Abscess)
By
Mitchtisha Jones
Boil or skin abscess is known as a restricted infection in the skin that began as a reddened, tender area. Over time, the area becomes firm, hard, and increasingly tender. Eventually, the center of the boil softens and becomes filled with infection-fighting white blood cells from the bloodstream to get rid of the infection. Pus is formed when white blood cells, bacteria, and protein collects under the skin. The pus, then “forms a head." which can be surgically opened or may all of a sudden drain out through the skin. Boils can take place anywhere on the body. (E Medicine Health)
Symptoms
A skin abscess, also named a boil, is a bump that appears within and on the surface of the skin. This bump is usually
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filled with pus or clear fluid, and is the result of a bacterial infection. A skin abscess may appear on any part of the body. However, they are most commonly found on the back, face, and chest. If the infection is left untreated, it can spread to the tissues under the skin and even into the bloodstream. If the infection spreads into deeper tissues, you may develop a fever and began to feel sick. (WebMD 2005-2016) Treatment Abscesses can be treated in a number of different ways, depending on the type of abscess and how large it is. The main treatment options include: Antibiotics- A course of antibiotics will usually be given before a specific type of bacteria has been acknowledged, so “broad-spectrum” antibiotics will primarily be given. These are designed to work against a wide range of known infectious bacteria and will usually cure most common infections. Once a specific bacterium has been identified from a pus sample, also known as a “Culture” a more “attentive” antibiotic can be used. Then there is a drainage procedure- you will possibly have a small operation usually under local anesthetic. The patient remains awoke and the area around the abscess is numbed. During the procedure, the surgeon will make an incision in the abscess, to allow the pus to drain out. They may also take a sample of pus for testing. Once all of the pus has been removed, the surgeon will clean the hole that is left by the abscess using sterile solution. The abscess will be left open but covered with a dressing, so if any more pus is produced it can drain out easily. If the abscess is deep, an antiseptic dressing will typically be placed inside the wound to keep it open. This procedure may leave a small scar. Lastly, Surgery is another form of treatment. If the center abscess is too large to be drained, if a needle cannot get to the abscess safely, or if needle drainage has not been effective in removing all of the pus, you may need to undergo surgery. (E Medicine Health 07/24/2016) Research Studies show that it has been more than ten years since doctors began to study and find a plan on how to diagnose, treat and prevent this strong form of staph infection (MRSA).
Studies also show that this bacterial infection is immune to many antibiotics, which makes it hard to find a treatment. Researchers from UCLA have updated guidelines outlining the top ways to treat and deal with these abscesses. The number of MRSA cases has amplified severely over the decade. MRSA and other skin infections can be transmitted from person to person, an individual should be careful to keep lesions covered with a dressing; and wash hands thoroughly after touching the affected area. Research says, if you see a skin infection beginning, you should see your doctor and also avoid sharing personal items, such as towels, razors or brushes with people who have an active infection. (UCLA …show more content…
Newsroom) Personal Experience In August 2014, I had a traumatic experience with skin abscesses also known as boils.
On my left hip I had a slight bump, over time it became soft and increasingly tender. I was told by numerous people that it was a boil, and it came from some form of infection and that it was easy to get rid of. As the days went by my, boil was not getting any better, and any touch or bump to my hip was causing excruciating pain. I do remember being told that applying a hot compress to the area will alleviate the pain. On week two, there was no change in my condition; I’ve done hot compresses, soaked in extremely hot water and even tried a heating pad. Given up all hope, I just decided to go to the hospital, while in the examination room, I was told that I was going to have to get the boil “lanced.” Lancing a boil means, to make a surgical incision so the pus can drain out since all the other options have been exhausted. I was numbed with a local anesthetic and my skin abscess was cut open drained and then packed with gauze. The nurse informed me to take an antibiotic and after one week to get in the shower and remove the gauze. One week goes by, and as I’m removing the gauze I notice my boil was yellow and still had pus oozing from the incision. After showing a couple of my family members I was told to go back to the hospital, because something was not right. Long behold, we are now on the third week of dealing with this skin abscess, the hospital staff told me that I had a severe
infection. The infection that I had was from not being on the right type of antibiotics. I was then taken into an examination room once again, giving an exam and the staff took a culture, which was not obtained the week prior. I was told I did not have one set of bacteria that they thought I had, which was called “Staph” I in fact had “MRSA” which was a whole different strand of bacteria. The hospital prescribed me a different prescription and in about five days I started to see a difference in the look and feel of my skin abscess. I can say, ten months later I still have a scar on my hip the size of a fifty cent piece with a lot of scar tissue under it, and I am now petrified of skin abscesses. I pray that one day someone will come up with a way for a person to not get a boil, but until they do; I just continue to wash my hand periodically and disinfect everywhere I go, and on everything I touch. Works Cited Champeau, R. (2014, 03 12). UCLA Newsroom. Retrieved from New treatment guideline for skin acscesses caused by MRSA: http://newsroom.ucla.edu/releases/new-guidelines-for-treating-skin-268853 Frederick B. Gaupp, M. (2015, 08 15). E Medicine Health . Retrieved from Boils: http://www.emedicinehealth.com/boils/article_em.htm M.D., L. J. (2016, 05 19). WebMD. Retrieved from Abscess: http://www.webmd.com/skin-problems-and-treatments/ss/slideshow-boils
Education of the patient will begin. Depending on the size of the abscess and how extensive the procedure was the patient may need a relative or friend to drive them back home. Not only would the patient need a ride back home, they may need to be watched for 24 hours. As part of pain management pain medication may be given to the patient to decrease pain. Antibiotics may be given to fight or prevent infection caused by the bacteria. The patient will also need to list all medications that they are taking so there will not be any contraindications with the medications that the patient is given. Advise the patient that more than one follow-up appointment will be necessary in order to properly treat the wound. Before the end of the appointment, the medical assistant should give the patient written instructions along with an emergency number and the number to the practice incase the patient has any questions or concerns. Advise the patient to return to the practice if they experience any fever, chills, or the abscess returns. If red streaks appear around the wound tell the patient to call the emergency department immediately. After the the procedure and patient education has been completed, make sure all the step of the procedure has been documented in the patient’s record and all follow-up procedures have been
Hidradenitis Suppurativa (HS) is a chronic skin condition that features lumps under the skin that range from pea-sized to marble sized. This condition is also known as acne inversa. Hidradenitis Suppurativa is NOT contagious. This condition usually occurs where skin rubs together such as between the buttocks, under the breasts, the armpits and the groin. Most of these lumps tend to be very painful and when they break open they often produce malodorous pus.
Pressure ulcers development occurs in every hospital and it remains a major worldwide health problem for many years. However, pressure ulcers have received minimal attention when we talk about it as a patient safety issue. It is a patient safety issue as it can lead to serious damage such as life-threatening infections and pain (Richardson & Barrow, 2015). On a med/surg unit, individuals may experience long or short hospital stays depending on the situation. For the short stays, the focus of care is often on regaining activities of daily living (Registered Nurses’ Association of Ontario, 2011). Therefore, assessment and education regarding pressure ulcers is often minimal or non-existent (RNAO, 2011). Every client who is at risk needs to be assessed and educated regarding pressure ulcers and the subsequent skin breakdown (Cooper, 2013). During the hospital stay, clients may have limited movement and pressure ulcers can extend into the muscle, tendon, and bone (RNAO, 2011). In many cases, clients do not notice the formation of an ulcer and as it may be in areas that are out of sight such as the coccyx. Often,
...y infections that could cause short term or long term unneeded damage. For this reason doctors and health care professionals are recommending that all people of all ages to get theses vaccines (University of Maryland Center, 2014). Other ways to prevent this disease are to simply keep clean and be aware of good hand hygiene (University of Maryland Center, 2014). By washing your hands with antimicrobial soap and warm water with friction, most bacteria are killed. Doing this prevents organisms from potentially getting inside your body.
According to the Centers for Disease Control and Prevention (2013), MRSA is easily transmitted from person to person or from touching materials or surfaces that had previous contact with the infection. Using the implementation of infection control along with patient education will help in the decrease of the spread and help in the prevention in MRSA as well as get patients involved in their own care. The purpose of this paper is to present the problem of MRSA as well as include the rationale and history, review the proposed solution, integrate an implementation plan, summarize the literature review, establish an implementation plan, use a nursing theory to support the implementation plan, use a change theory to support the implementation plan, discuss how the project will be evaluated, and create a dissemination
Timeliness in medical care can be of the utmost importance. Letting things progress can result in a slippery circle, where a minor infection, untreated end up being life threatening. With increased damage caused by neglecting health care, or waiting on a health care provider, the physical damage, and costs associated increase, often exponentially.
When a patient is seen in the ED for a wound, the doctor generally starts the patient on antibiotics before the results of the wound cultures are in. Once these results are in, the PVRN is responsible for making sure the antibiotic is appropriate to treat the patient. If it is not, the PVRN must contact the patient’s primary care physician who is then responsible for making sure the patient is put on the correct antibiotics. Unfortunately, there are some primary care providers who refuse to do this because they were not the ones that ordered the test. The PVRN must then explain to the primary care physician that they are responsible for the patient’s overall health and should be the ones to address the issue. The PVRN must also explain that it is often not possible for the doctor who ordered the test to follow up with the patient due to the differing schedules of the ED doctors. This means that if the PVRN were to get the new orders from an ED doctor, it would likely be one that has never seen the patient. Therefore, in order to ensure the best quality of care for the patient, the primary physician should arrange the treatment. If the primary care physician still refuses to take action, then the PVRN must inform the ED Medical Director of the situation so that it can be
Even though S. aureus is mainly associated with food poisoning, the bacterium can penetrate the skin or other mucous membranes to invade a range of tissues which will cause a variety of infections. Superficial infection of the skin can cause boils, impetigo, styes (infection of the glands or hair follicles of the eyelids), folliculitis, and furnacles. All of these infections are charac...
Necrotizing Fasciitis (flesh eating bacteria ) from an essay by Katrina Tram Duong, edited by S.N. Carson M.D.
Cellulitis is an acute spreading bacterial infection of the connective tissue, dermis and subcutaneous layers of the skin (ProQuest 07/2012 pg.5). Characterized by redness, swelling, warmth, tight/shiny skin and pain. It is sometimes accompanied by fever, swollen lymph nodes, chills and fatigue. Cellulitis first appears on pink-to-red minimally inflamed skin. The area of infection rapidly becomes deeper red and increases in size as the infection spreads. Occasionally, red streaks may radiate outward from cellulitis. Blisters or pus filled bumps may also be present (skinsight 12/2012 pg.5). The main culprit is the bacteria Streptococcus and Staphylococcus which can enter through a break in the skin.
Pressure ulcers are one of the most common problems health care facilities often face which causes pain and discomfort for the patient, cost effective to manage and impacts negatively on the hospital (Pieper, Langemo, & Cuddigan, 2009; Padula et al., 2011). The development of pressure ulcers occur when there is injury to the skin or tissue usually over bony prominences such as the coccyx, sacrum or heels from the increase of pressure and shear. This injury will compromise blood flow and result in ischemia due to lack of oxygen being delivered (Gyawali et al., 2011). Patients such as those who are critically ill or bed bounded are at high risk of developing pressure ulcers (O'Brien et al., 2014).
Patient education is of paramount importance if MRSA is to be reduced to its lowest minimum. According to Noble 2009, patient’s education stands a critical component of managing MRSA therefore; nurses are expected to be prompt in educating patients on specific measures in limiting and reducing the spread of MRSA by person to person contact. (Noble, 2009) The specific measures includes definition of MRSA, mode of transmission, the damage it can do to the body, specific treatments available and the process of treatment. This is to help the patient take part in the care. Noble 2009 explains that during care giving nurses and all other healthcare provider involve in giving care to a patient should communicate to patient all the precaution that will prevent the transmission of MRSA, and also giving the scientific rationale for the use of any precaution that is been used in the cause of care giving. (Noble, 2009.)
Infection control is very important in the health care profession. Health care professionals, who do not practice proper infection control, allow themselves to become susceptible to a number of infections. Among the most dreaded of these infections are: hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). Another infection which has more recently increased in prevalence is methicillin-resistant Staphylococcus aureus (MRSA). These infections are all treated differently. Each infection has its own symptoms, classifications, and incubation periods. These infections are transmitted in very similar fashions, but they do not all target the same population.
Our approach in managing wounds was far from being optimal in our own setting. After having read the article of Sibbald et al (1) and assisting to presentations during the first residential week-end, our approach at St. Mary 's Hospital Center 's Family Medicine Clinic must change. We were not classifying wounds as healable, maintenance or non-healable. We were always considering the wounds in our practice as healable despite considering the system 's restraints or the patients ' preferences. In the following lines, I will define and summarize the methods one should use in order to initial management of wounds and how to integrate it better to our site. The first goal we need to set is to determine its ability to heal. In order to ascertain if a wound is healable, maintenance or a non-healable wound.
Cellulites is another dry skin condition, where the skin layers are inflamed due to a bacterial infection. It is best to take care of dry skin as soon as you know you have it, rather than allow more serious complications to develop.