J Oral

Moxillofac

Surg

57:207-208,

1999

A Simple

Technique
for Intraoral
Placement
and Fixation
Michael

H. Kirsch, DDS, * and Alan Samit,

Received
Department
*Former

from

1. Suture

the Department

of Veterans

tied

to drain.

of Oral and Maxillofacial

Affairs Medical

DDSf

distance from the incision (Fig 2). The drain is gently

pulled to the depth of the abscess by pulling on the
suture, and the suture is then tied to itself, superficial
to the mucosa (Pig 3). The knot used is similar to the
one used on the end of a pullout suture. A suture
throw is placed around the needle holder, the suture

Incision and drainage remain the standard of care for

treatment of a fluctuant dentoalveolar abscess. In our
experience, the most awkward
and time-consuming
part of the procedure involves placing and securely
fixing the drain at the depth of the abscess. We have
developed a novel technique that simplifies placing
and securing the drain within an abscess cavity. A
small length of Penrose drain is fashioned with a knot
at one end. A 3-O black silk suture on a tapered needle
is passed through the knot of the drain and tied
securely (Pig 1). After incision of the mucosa and
decompression
of the abscess, the suture is passed
through the incision into the depth of the abscess
cavity and brought out through the mucosa at some

FIGURE

Drain

Center,

Sui-get-y,

East Orange,

NJ.

Chief Resident.

tChief.
Address

correspondence

Ridge Dr, Montville,

and reprint

requests

Q 1999 American Association of Oral and Maxillofacial

0278.2391/99/5702-002

to Dr Kirsch:

133

NJ 07045.
Surgeons

FIGURE
mucosa

1$3.00/O

207

2. Diagram
showing
in the depth of the abscess

passage
cavity.

of the

suture

through

the

208

FIGURE
position.

KIRSCH

3.

Suture

tied

on surface

of the mucosa

to hold

the drain

in

is grasped as it emerges through the mucosa, and the

first knot is tied directly on top of the tissue. This
produces a small loop that allows additional knots to
be placed.

MODIFICATION

OF TRADITIONAL

I&D

This technique has several advantages over tying

the drain to the edge of the incision. First, it assures
that the drain will be located at the depth of the
abscess cavity. This is important to assure optimal
drainage. Second, it secures the drain away from the
incision, minimizing early loss that can occur because
of tissue inflammation or necrosis. Third, the process
of placing and securing the drain is simple and rapidly
accomplished.
Finally, drain removal is much less
uncomfortable
for the patient. The suture is cut
directly below the knot, and the drain is easily
withdrawn.
We believe this technique to be easier, faster, and
more efficacious than traditional drain placement
procedures,
and we have used it exclusively
for
several years with excellent results.