foley as improvised Word catheter for Bartholin’s abscess

10 Jan

can’t find a Word catheter to keep a Bartholin’s gland abscess open after an I&D?  try this nice MacGuyver move from a recent ACEP News article:

 

WHY DOES THIS MATTER?

“Bartholin glands normally secrete lubrication into the vaginal vestibule via small ducts, but if they become occluded, cyst and abscess formation may follow.”

“…likely to recur if we do not ensure that a new duct can form to allow the gland to drain normally.”

one common way is to leave a Word catheter in place for 2-4 weeks

 

WHAT WOULD MACGUYVER (or Dr. Fisher, article author) DO?

YOU NEED:

  • peds foley catheter (8 or 10 French)
  • hemostats
  • scissors
  • cyanoacrylate tissue adhesive (e.g. Dermabond)
  • PPD or insulin syringe
  • usual I&D kit

 

MAKE IT WORK:

  • I&D as usual
  • insert deflated foley into abscess cavity
  • inflate with 3-4mL saline/water
  • clamp foley with hemostat a few cm distal to baloon
  • cut catheter distal to clamp
  • draw up some Dermabond into insulin/PPD syringe
  • inject adhesive directly into balloon channel (smaller, non-central, not-for-urine) 
  • may need more than one round of adhesive
  • give it a few minutes, then remove hemostat
  • balloon can be deflated after 2-4 weeks by cutting the catheter again (include discharge instructions if the follow-up doc may be unfamiliar with these)

 

Sounds cool.  Nice to have options.

 

References: acepnews article; word pic; foley pic

 

 

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