Abscess Drainage without Antibiotics?

I just read a paper this morning that gave conclusive evidence that antibiotics do not work after an Incision and Drainage procedure for an Abscess. That was rather surprising to me. How can a cavity that's filled with pus (essentially teeming with bacteria and what not) not respond to the very things that were invented to destroy said bacteria and what not!

The data suggested that there was no difference in the healing process in the placebo group and the group that received the antibiotics. They also report that the incidence of further infection was not affected by the antibiotics. So, 7 days after the incision, patients were no better no worse. I'm not so sure thats a good thing!

Taking this scenario and applying it in India would be akin to shutting your practice down. Why? Simple. Your patients will think you've lost it! "My doc is so stupid he didn't even prescribe me antibiotics". In a country that is widely known for abusing over the counter drugs, we have our chemist friends that happily dispense all antibiotics over the counter as well and almost no one I know asks for a prescription. Knowing this, do you think that even if I don't prescribe an antibiotic, I won't be asked for it? Wouldn't it just be bought anyway to 'be safe'?

Pharma companies - Lets not even get started there. They must already be conduction 'trials' to disprove this theory. Be realistic, if you won't prescribe antibiotics for an infection, what else is left??? (Of course, I'm generalising!)

                                                          

How about you? Would you feel comfortable not taking any antibiotics after getting a surgical procedure on your body to remove pus from an abscess cavity?? 

I want comments on this one!

Cosmetic or Fanatic

The world today amazes me. I realise that I am beginning to sound old and fuddy duddy types by saying something like this but I guess the change in perception of people towards people is just stark.

A lady who was to deliver her second child through a C section came into our path recently. What are surgeons doing with a delivery you might ask. Well, the thing is this lady was quite obsessed with her abdomen, in the sense that she wanted the perfect flat tummy that most people crave for. Towards this, she realised she had a swelling around her umbilicus which she thought was a hernia, and thats where we came in. Thats not all though, she also realised that having two babies made her tummy look like a stack of tyres so she also wanted a tummy tuck (liposuction), and she was quite adamant on this.

Without getting into the technical details of surgery, her previous pfannensteil incision was used along with a vertical one which went around the umbilicus upto the hernia. Only, there was no hernia. It was a perception of one, with lax rectus sheath being the cause. She delivered the baby (fortunately healthy), and got the tummy tuck under general anaesthesia.

The point in question is this: Would you rather take care of your new born baby and bother about how it looks or worry about how fat your tummy is going to look because you've had two babies? Worry about breast feeding or worry about staving off an infection because the surgery you asked for would need you to take antibiotics?? Are looks so important that you put it in the same league as having a baby??

I agree its a personal choice (even though it may be an unwise one) but this is a personal opinion. You'd have to be fanatical to worry so much about cosmesis!