Debriedment of abscess subsequent to self-envenomation
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After inducing with 5% iso delivered through a mask fitted to a Midwest professional snake restraint tube, the cobra was successfully intubated and maintained during surgery on 2.5% to 3% isoflourane. A cuffed endotracheal tube was used with slow and minimal inflation to avoid damaging the rigid airway. Soft plastic tubing and cloth tape was used to help hold the endotracheal tube in place. Lidocaine was injected as an additional local anesthetic. When the abscess was opened, we found necrotic tissue and extensive cellulitis. Aggressive debriedment was indicated.
A large amount of nonviable tissue was dissected away from the healthy muscle wall and preserved for cytology. Making sure that all the nonviable tissue was removed was a job requiring a good eye and steady hands. Magnification headgear can be very helpful. The wound is closed after debriedment, and the stitches are tacked to the muscle wall for better retention.
A drainage catheter is left in the wound for 72 hours, to be removed with his next dose of Ceftazidime. 72 hours later, the drainage catheter is removed and the wound appears to be healing well. Interesting looking eosinophils and bacterial chains showed up on the cytology smear.

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