I&D vs. I&D

  1. Okay, kids, at work this past weekend had a spinal surgery pt go to surgery to have an I&D d/t post op infection. I was under the impression that I&D stood for irrigation and debridement, but the nursing staff on the floor I was working on that night claimed that it stood for Incision and Drainage. I googled it and these titles seem to be synonymous. Which way is correct?
    •  
  2. 12 Comments

  3. by   AngelfireRN
    I personally have only ever heard it used to describe Incision and Drainage. We always called the other "debridement". Be interesting to see what others have seen/heard.
  4. by   kool-aide, RN
    Thanks for your reply, Angel. Of course, unbeknown to me, the pt was actually a NP and here I go blabbering on about her "irrigation and debridement." lol I felt so silly afterwards but like I said, after looking it up, Incision and drainage and irrigation and debridement seem to be synonymous.. oh well!
  5. by   AngelfireRN
    I'm an NP, and I would have just smiled and nodded, lol. Don't sweat it, this is how everyone learns!
  6. by   xtxrn
    Incision and debridement. Unless it's incised, it's near impossible to mechanically debride. Seen this with necrotic decubs- no drainage to be found- just "crust" and nasty purpley-black stuff.

    Incision and drainage? Yeah- that, too. And have had that done-- but don't remember what they called it- LOL - just I & D. And with an infection, this sounds reasonable.

    Irrigation and debridement??? Only if using sulfuric acid You'd need some serious psi to blow off dead tissue, which would cause more damage - and if it's just hanging there, you'd more likely just need a good sterile swabbing
  7. by   xtxrn
    My kudos won't work for AngelfireRN- agree w/her-- learning is a process
  8. by   vanburbian
    6 of one, half dozen of the other?
    They are opening some typically closed area up, and cleaning it.

    Irrigation is almost a given, as is some sort of "incision", debridement and or drainage would depend more specifically on what it is exactly...a pus filled spinal cord incision? drain- a necrotic wound?- likely a little of both.

    I will defer to an OR nurse.
  9. by   xtxrn
    Quote from hoopschick
    6 of one, half dozen of the other?
    They are opening some typically closed area up, and cleaning it.

    Irrigation is almost a given, as is some sort of "incision", debridement and or drainage would depend more specifically on what it is exactly...a pus filled spinal cord incision? drain- a necrotic wound?- likely a little of both.

    I will defer to an OR nurse.
    I've had patient's with tunneling wounds that were opened up on their own, so were irrigated- but then packed...

    We also had our PT who would whirlpool a crusty necrotic foot, and then go after it with a blade- so not irrigated, and not drained- but sliced in small increments to get to healthy tissue.

    There are a lot of combinations of what can be done; I & D shouldn't be written as just that- the doc should write the words out
  10. by   merlee
    Incision and drainage - - not the same as debridement, which is the mechanical removal of debris, hence debridement. I&D is used when the area is fluid-filled; could be purulent fluid.

    Also, debridement is frequently done on a recurrent basis, as in wet-to-dry dressings, or repeated procedures to remove eschar from a burned area or decubitus.

    I can see the confusion.
  11. by   Esme12
    I&D Incision and drainage......I refered to them as a poke and pour.... . Irrigation and debriedment is washing it out and clipping back dead skin to reveal healthy tissue.

    No sweat....we all have been there and learned.

    About once a year I am reminded to NEVER comment..."when are you due?"
  12. by   Elvish
    I have always heard it to mean 'incision and drainage' in several settings - general surgery, community health (we did a TON of it), and OB.

    But just because I've never heard it called something else doesn't mean the term doesn't exist. Ah well....live and learn.
  13. by   ZippyGBR
    Quote from AngelfireRN
    I personally have only ever heard it used to describe Incision and Drainage. We always called the other "debridement". Be interesting to see what others have seen/heard.
    i'd agree with that

    I+D is incision and Drainage

    a debridement is a debridement
  14. by   xtxrn
    Quote from merlee
    Incision and drainage - - not the same as debridement, which is the mechanical removal of debris, hence debridement. I&D is used when the area is fluid-filled; could be purulent fluid.

    Also, debridement is frequently done on a recurrent basis, as in wet-to-dry dressings, or repeated procedures to remove eschar from a burned area or decubitus.

    I can see the confusion.
    Yeah, I learned that debridement can be mechanical or chemical. Totally different animals I forget the name of the old standby ointment we'd use with Bactroban on wounds.

close