Incision and Drainage of a Skin Abscess Overview

An abscess is an inflamed and infected pocket of pus in the skin. It is often called a boil . Incision (cut) and drainage is a procedure to drain pus from an abscess.

Incision and Drainage

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Prior to Procedure

• Your doctor will examine the abscess.

• An ultrasound or other imaging technique may be done if the abscess is large or deep. Blood tests may also be used to find out how severe the infection is.

• Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

• Aspirin or other anti-inflammatory drugs
• Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)

• Your doctor will make sure your tetanus immunizations are current.

Anesthesia

A local anesthesia will be applied to your skin. This will make the area numb.

Description of Procedure

Most of the time, this procedure can be done in your doctor’s office. Larger, deep abscesses, or abscesses in very sensitive areas (eg, near the anus), may require treatment in the hospital.

The area will be wiped with a special cleansing fluid. Anesthesia will be applied. A small incision will be made. A syringe or catheter may be used to drain the pus from the abscess or the pus may be squeezed out. Gauze may be used to soak up the fluid. A clean water solution will be used to flush the area.

A tool may be used to explore inside the cut. It can also further break down the abscess. A sample of the bacteria may be taken with a cotton swab for testing. Sometimes, the doctor will decide to pack the wound with clean gauze to help make sure the abscess does not form again. If this happens, you will come back in a day or two to remove or replace the packing. Gauze and dressing tape will be used to cover the wound.

How Long Will It Take?

30-45 minutes

Will It Hurt?

No, the procedure should not hurt. You may feel a slight pinch and burning when the local anesthetic is injected.

Post-procedure Care

At Home

When you return home after the procedure, take the following steps to help ensure a smooth recovery:

• Take all medicine as directed. If you are taking an antibiotic, take it at the same time(s) each day. Finish the entire course.

• Change your bandages 1-3 times a day as directed. Replace them with sterile bandages that your doctor gives you.

• Cleanse the incision site with lukewarm water and a mild antibacterial soap.
• Use a soft wash cloth to gently wipe the incision area dry.

• You may need to limit movement of the affected area to give it time to heal.

• Follow up with your doctor as directed.

The skin should heal completely in about 14 days.

RESOURCES:

American Academy of Dermatology
http://www.aad.org/

American Academy of Family Physicians
http://www.aafp.org/

American College of Surgeons
http://www.facs.org/

CANADIAN RESOURCES:

Canadian Association of Wound Care
http://www.cawc.net/

The Canadian Society of Plastic Surgeons
http://www.plasticsurgery.ca/

Canadian Task Force on Preventive Health
http://www.ctfphc.org/

References:

Calvagna M. Boils. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15&topicID=81 . Updated November 17, 2008. Accessed May 21, 2009.

Fitch M, Manthey D, McGinnis H, et al. Abscess incision and drainage. The New England Journal of Medicine (Videos in Clinical Medicine). 2007. 357;19. PDF Available at: https://secure.muhealth.org/~ed/students/articles/NEJM357pe0020.pdf . Accessed May 21, 2009.

NHS Clinical Knowledge Summaries. Abscess treatment. NHS Clinical Knowledge Summaries website. Available at: http://www.cks.nhs.uk/patientinformationleaflet/abscess/treatment . Accessed May 21, 2009.

Prevention of surgical site infections: Prevention and Control of Healthcare Associated Infections in Massachusetts. AHRQ National Guideline Clearinghouse website. Available at: http://www.guideline.gov/summary/summary.aspx?doc_id=12921&nbr=6635&ss=6&xl=999 . Accessed May 21, 2009.

University at Buffalo (The State University of New York). Abscess incision and drainage. University at Buffalo (The State University of New York) website. Available at: http://apps.med.buffalo.edu/procedures/abscess.asp?p=1 . Accessed May 21, 2009.