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Surgical site infection — USMLE Step 3 MCQ

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ModerateSurgery (post-operative, follow-up)Surgical site infectionUSMLE Step 3

A 47-year-old woman returns 8 days after open cholecystectomy with increasing incisional pain and purulent drainage. Temperature is 38.3 C. The wound is erythematous and fluctuant. Which of the following is the most appropriate next step in management?

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Correct answer: B — Open the incision and drain the wound

Purulent incisional infection requires opening the wound for drainage, with antibiotics when systemic features or cellulitis are present.

Reference: American College of Surgeons perioperative care principles