Hilton’s Method of Incision and Drainage

What is Hilton’s Method of Incision and Drainage?
The method of opening an abscess ensures that no blood vessel or nerve in the viscinity is damaged and is called Hilton’s method.

What are the Steps of Hilton’s Method of Incision and Drainage?

There are total 10 Steps of Hilton’s Method of Incision and Drainage. These are as follows.
1. Topical anaesthesia: Topical anaesthesia is achieved with the help of ethyl chloride spray.

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2. Stab incision: made over a point of maximum fluctuation in the most dependent area along the skin creases, through skin and subcutaneous tissue.
3. If pus is not encountered, further deepening of surgical site is achieved with sinus forceps (to avoid damage to vital structures).
4. Closed forceps are pushed through the tough deep fascia and advanced towards the pus collection.
5. Abscess cavity is entered and forceps opened in a direction parallel to vital structures.
6. Pus flows along sides of the beaks.
7. Explore the entire cavity for additional loculi.
8. Placement of drain: A soft yeat’s or corrugated rubber drain is inserted into the depth of the abscess cavity; and external part is secured to the wound margin with the help of suture
9. Drain left for at least 24 hours.
10. Dressing: dressing is applied over the site of incision taken extraorally without pressure.

What is The Purpose of keeping the drain?
The purpose of drain is

  • To allow the discharge of tissue fluids and pus from the wound by keeping it patent.
  • The drain allows for debridement of the abscess cavity by irrigation.
  • Tissue fluids flow along the external surface of a latex drain.

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