I&D Submandibular Abscess

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Preoperative Considerations


  • IAN/Lingual nerve damage
  • Facial nerve weakness
  • Need for repeat drainages


  • Oral tube OK if possible
  • Assess airway, if trismus



  • Surgical drapes
  • Sterile gloves
  • Surgical gowns
  • Surgical masks
  • Eye protection
  • Anesthetic drugs (local or general)
  • Syringes and needles
  • Anesthesia machine (if using general anesthesia)
  • Scalpel with No. 15 blade
  • Hemostats
  • Curved mosquito forceps
  • Suction device
  • Sterile saline solution
  • Culture swabs
  • Penrose drain
  • Dental elevators
  • Dental forceps
  • Surgical handpiece and burs
  • Bone file
  • Rongeur
  • Absorbable sutures
  • Non-absorbable sutures
  • Needle holder
  • Suture scissors
  • Gauze pads
  • Sterile water or saline
  • Mouth mirror and explorer
  • Antibiotics and pain management medications
  • Postoperative dressing materials


Postoperative Considerations


Follow Up:

Operative Note

Surgeon(s): ***

Assistant Surgeon(s):  ***

Preoperative Diagnosis: ***

Postoperative Diagnosis: Same

Procedure(s): ***

Anesthesia: General

Implants: None


Drains: None

Fluids: See anesthesia record

EBL: Minimal

Complications: None

Counts:  Correct x2

Indications: ​***

Findings: As expected

Procedure in Detail:

The patient was seen in the preoperative holding area with a H&P was updated, consents were verified, surgical site marked, and all questions and concerns related to the proposed procedure were discussed in detail.  The patient was transferred to the operating room by the anesthesia team.  The patient underwent general anesthesia with endotracheal intubation. Tegaderms were placed over the eyes. The patient was prepped and draped in the standard fashion for maxillofacial procedures.  A time-out was performed and the procedure began.

A 3 cm incision was made over the most fluctuant area of the submandibular region. Pus was encountered immediately upon incision, confirming the presence of an abscess. Approximately 15 ml of purulent material was evacuated. The cavity was explored thoroughly for any loculations, which were broken down, and the abscess cavity was irrigated with sterile saline solution. Attention was turned to the source tooth. The overlying gum was incised and retracted, exposing the tooth. The tooth was sectioned using a surgical drill, and the pieces were carefully extracted. The area was thoroughly debrided and irrigated to ensure complete removal of all dental debris and potential sources of infection.A small Penrose drain was placed to facilitate continued drainage and was secured with a skin suture.

The patient's face was then cleaned and the posterior pharynx was suctioned. An OG tube was used to suction out the contents of the stomach. Tegaderms were removed from the eyes. Dressings were placed. The patient was then transferred back to the care of the anesthesia team for extubation and recovery.


  • 40800/D7510 Drainage abscess, cyst, hematoma of vestibule simple
  • 40801/D7511 Complex intra-oral abscess
  • 41008/D7510 /D7511 Intraoral I&D submandibular space and floor of mouth
  • D7510 I&D of abscess, intraoral soft tissue
  • D7511 I&D of abscess, intraoral soft tissue complex
  • 41009/D7510/D7511 Intraoral I&D masticator space
  • 42000/D7510 Intra-oral I&D drainage abscess palate or uvula
  • 42310/D7510 Intra-oral I&D drainage of sublingual space
  • 42720/ D7510/D7511 Intraoral I&D parapharyngeal space
  • 42700/ D7510/D7511 Intraoral I&D peritonsillar space
  • 97597/NA Washout procedure
  • A/D7111 Removal or coronal remnants
  • NA/D7140 Extraction, erupted tooth or exposed root
  • NA/D7210 Extraction, erupted tooth-requiring removal of bone and or section tooth and including elevation of mucoperiosteal flap
  • NA/D7250 Removal of residual tooth roots
  • NA/D7220 Removal of impacted tooth- soft tissue
  • NA/D7230 Removal of impacted tooth- partially bony
  • NA/D7240 Removal of impacted tooth- completely bony
  • NA/D7241 Removal of impacted tooth- completely bony with unusual surgical complications
  • NA/D7251 Coronectomy