[Desensitisation]

She certainly could have made sure the drain-off was better set up (ie stick the shield plastic in place BEFORE incising), but the prep, incision, and packing itself was perfectly acceptable.

[Desensitisation]

Originally Posted by HouseAtreides ↗

According to someone on youtube:

-patient should be assuming prone position

Agreed.

-patient should have received at least low dose pre op. opioid analgesia(ie: hydromorphone 2mg IV)

Unnecessary, and we don't know if patient had opioid sensitivity, which 10% of people have adverse reactions with.

-Sub standard povidone iodine application, should cover way more of the affected area and lower as well

Agreed

-initial infiltration with lido: epi sub standard , should have at least 5 injection sites for an infection of these dimensions

Unnecessary initially, unless a larger incision was demanded or further exploration of damage was undertaken, which was done later.

-did not assess patient for adequate nerve block after infiltration, didn't even give him 1 minute for acceptable anesthesia she just incised him immediately.

Most preparations of lidocaine/lignocaine at subcut level have near-immediate effect, both from personal experience, and use in my own field.

-proof of subcutaneous nerve block inadequate as you can see her probe the loculi up towards his shoulder and he verbalizes severe pain.

Agreed: additional blocking should have been done when extent of abscess cavity was established.

-patient requests increase dose of infiltrate/ anesthesia only to be met by a long needle loaded syringe probing the incision site, clearly they only place that's ALREADY received the nerve block

SOP to proceed from already inflitrated area to reduce discomfort.

-needle penetrates deep enough to push pathogens deeper in unaffected tissue

Not convinced of that on my viewing, but youtube video quality looking pretty crappy on my end...

-all expendables are being used sub acceptable methods of practice. Custodian linens bag or equivalent used and completely contaminated sterile field rendering the entire operating area not only unsterile but biologically hazardous

Definitely agreed.

-irrigation sub standard as aforementioned by other comments

I think I have to watch this video again when youtube isn't being a dick...

-packing procedure completely unacceptable. Trailing end dragging through contaminated field, insufficient packing if she's gonna use the strip

Okay, I definitely have to watch this vid when it isn't a blocky mess...

-did not opt for medical polymer wick in lieu of ridiculous packing job

Even a penrose drain would have been better...

-no assistance from nurse, (ie: nurse could have implored or even implement use of a drip tray (kidney shape vesicle) and opened more gauze leaving them on the sterile wrapper for the DC.

Agreed.

-no drape -half hearted prep, clean up before during and after op

Yep.

-NO CULTURE TAKEN

I guess that's SOP in the USA... isn't around here.

-and if the hospitals defense council challenges the woman recording saying things like "good job Dr you've done great" you assert ignorance of due process until the footage was examined. The only thing she did that made you FEEL she did a good job, was evacuate the discharge from the wound. The release of pressure seems like a great favor and you simply challenge back saying ignorance of acceptable standards and methods of practice is NOT an admission of not being an injured party.

Lawyers!

[Desensitisation]

Okay, Youtube working now.

I wish to retract my initial assessment. That was pretty roughly done.

Where's the edit button gone? Used to be there, now it's not...

[vagabond]

Well, I myself would like to see follow up vids on this particular guy; did he develop other infections, etc.
Great posts

[Sharon]

Abcessess are revolting things to endure

[mitzy_69]

They are even more revolting if you're scrubbed and the surgeon while using saline to flush out the cavity accidentally manages to squirt you in the face......

[Nwhite]

Originally Posted by Mollydoublybarrly ↗

What did she stuff inside that thing at the end?

She certainly made a hash of that

They put "packing" inside the cleaned out abscess, it helps the wound to heal faster and better. I saw that this video was titles something about a botched abscess removal? aside from the mess she made, it looked pretty textbook to me.

[yesss]

Originally Posted by kellyhound ↗

could have done a back shave while she was at it.

Or even better, before...

[Lion-hearted Girl]

Yeh, what a mess.

[flyflicker123]

might as well shave the rug too