Surgical Infections — MCQs

Q: What is the most appropriate treatment for acute paronychia?

Partial nail removal. **Explanation:** Acute paronychia is a localized infection of the nail fold, most commonly caused by *Staphylococcus aureus*. The management depends on the stage of the infection and the presence of an underlying abscess. **Why Partial Nail Removal is Correct:** In cases of acute paronychia where an abscess has formed beneath the nail plate (subungual extension), simple incision of the soft tissue is insufficient. **Partial nail removal** (specifically of the lateral edge of the nail) is the most effective treatment because it ensures complete decompression of the subungual space and allows for adequate drainage of the infected pocket. This approach prevents recurrence and promotes faster healing compared to simple soft tissue drainage. **Analysis of Incorrect Options:** * **B. Nail Removal:** Complete nail avulsion is overly aggressive for a localized paronychia and is generally reserved for severe fungal infections (onychomycosis) or extensive subungual trauma. * **C. Lifting of the Eponychium:** This technique (using a flat probe or elevator) is used for very early, superficial paronychia. However, it is often inadequate if the pus has already tracked under the nail plate. * **D. Incision and Drainage:** While I&D is standard for most abscesses, in paronychia, a simple skin incision often fails to drain the subungual component, leading to treatment failure. **High-Yield Clinical Pearls for NEET-PG:** * **Most common organism:** *Staphylococcus aureus* (Acute); *Candida albicans* (Chronic). * **Chronic Paronychia:** Defined as lasting >6 weeks; treatment involves avoiding moisture and topical steroids/antifungals (Marsupialization is the surgical option). * **Felon:** An infection of the pulp space of the finger; requires a lateral longitudinal incision to avoid damaging the digital nerves and vessels.

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Surgical Site Infections

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Intra-abdominal Infections

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Soft Tissue Infections

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Surgical Sepsis

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Tetanus Prophylaxis

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Antimicrobial Prophylaxis

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Antimicrobial Therapy in Surgical Infections

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Surgical Drainage Procedures

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Infection Control in Operating Room

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Prevention Strategies

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