To truly, quickly, and effectively provide anesthesia to infected skin prior to procedures such as incision and drainage of simple soft tissue abscesses, consider the use of topical ethyl chloride.

This tricks the tissue into feeling “frozen” and allows for immediate and safe analgesia. Given the inflammatory nature of infected soft tissue and the limited utility of the usual injectable agents in this setting, I have found significant patient satisfaction using this modality. — Joe Yonke, MSBS, MPH, PA-C, Cleveland. (196-4)



These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.


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