Abscess incision and drainage

Common sites of abscess above and below the liver

Fig.1.3.

Definition

An infected skin nodule that contains pus may need to be drained via a cut if it does not respond to antibiotics. This allows the pus to escape, and the infection to heal.

(Fig.1.3.)
Although abscesses are often found in the soft tissue under the skin, such as the armpit or the groin, they may develop in any organ, such as the liver.


Purpose

An abscess is a pus-filled sore, usually caused by a bacterial infection. The pus is made up of both live and dead organisms and destroyed tissue from the white blood cells that were carried to the area to fight the infection. Abscesses are often found in the soft tissue under the skin, such as the armpit or the groin. However, they may develop in any organ, and are commonly found in the breast and gums. Abscesses are far more serious and call for more specific treatment if they are located in deep organs such as the lung, liver or brain.
Because the lining of the abscess cavity tends to interfere with the amount of the drug that can penetrate the source of infection from the blood, the cavity itself may require draining. Once an abscess has fully formed, it often does not respond to antibiotics. Even if the antibiotic does penetrate into the abscess, it doesn't function as well in that environment.



Precautions

An abscess can usually be diagnosed visually, although an imaging technique such as a computed tomography scan may be used to confirm the extent of the abscess before drainage. Such procedures may also be needed to localize internal abscesses, such as those in the abdominal cavity or brain.

Description

A doctor will cut into the lining of the abscess, allowing the pus to escape either through a drainage tube or by leaving the cavity open to the skin. How big the incision is depends on how quickly the pus is encountered. Once the abscess is opened, the doctor will clean and irrigate the wound thoroughly with saline. If it is not too large or deep, the doctor may simply pack the abscess wound with gauze for 24-48 hours to absorb the pus and discharge. If it is a deeper abscess, the doctor may insert a drainage tube after cleaning out the wound. Once the tube is in place, the surgeon closes the incision with simple stitches, and applies a sterile dressing. Drainage is maintained for several days to help prevent the abscess from reforming.

Preparation

The skin over the abscess will be cleansed by swabbing gently with an antiseptic solution.