An abscess is an infected skin nodule containing pus. It may need to be drained via an incision (cut) if the pus does not resolve with treatment by antibiotics . This allows the pus to escape, the infection to be treated, and the abscess to heal.
An abscess is a pus-filled sore, usually caused by a bacterial infection. The pus is comprised of both living and dead organisms. It also contains destroyed tissue due to the action of 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 an abscess cavity tends to interfere with the amount of 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 does not function as well in that environment.
Abcess drainage is a minor and common surgical procedure that is often performed in a professional medical office. Accurate records concerning the number of procedures are kept in private medical office rather than hospital records. For these reasons, it is impossible to accurately tally the number of abscess incision and drainage procedures performed in a year. The procedure increases in frequency with increasing age.
A doctor will cut into the lining of an abscess, allowing the pus to escape either through a drainage tube or by leaving the cavity open to the skin. The size of the incision depends on the volume of the abscess and how quickly the pus is encountered.
Cells normally formed for the surface of the skin often migrate into an abscess. They line the abscess cavity. This process is called epithelialization. This lining prevents drugs from reaching an abscess. It also promotes recurrence of the abscess. The lining must be removed when an abscess is drained to prevent recurrence.
Once an abscess is opened, the pus drained, and the epithelial lining removed, 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 or surgeon 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. The tube is removed, and the abscess allowed to finish closing and healing.
An abscess can usually be diagnosed visually, although an imaging technique such as a computed tomography (CT) scan or ultrasound 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.
Prior to incision, the skin over an abscess will be cleansed by swabbing gently with an antiseptic solution.
Much of the pain around an abscess will be gone after the surgery. Healing is usually very rapid. After the drainage tube is removed, antibiotics may be continued for several days. Applying heat and keeping the affected area elevated may help relieve inflammation.
Any scarring is likely to become much less noticeable as time goes on, and eventually become almost invisible. Occasionally, an abscess within a vital organ (such as the brain) damages enough surrounding tissue that there is some permanent loss of normal function.
Other risks include incomplete drainage and prolonged infection. Occasionally, an abscess may require a second incision and drainage procedure. This is frequently due to retained epithelial cells that line the abscess cavity.
Most abscesses heal after drainage alone. Others may require more prolonged drainage and antibiotic drug treatment.
Morbidity associated with an abscess incision and drainage is very uncommon. Post-surgical problems are usually associated with infection or an adverse reaction to antibiotic drugs prescribed. Mortality is virtually unknown.
There is no reliable alternative to surgical incision and drainage of an abscess. Heat alone may cause small superficial abscesses to resolve. The degree of epithelialization usually determines if the abscess reappears.
See also Incision care ; Wound care .
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L. Fleming Fallon, Jr, MD, DrPH
Abscesses are most commonly incised and drained by general surgeons. Occasionally, a family physician or dermatologist may drain a superficial abscess. These procedures may be performed in a professional office or in an outpatient facility. The skin and surrounding area may be numbed by a topical anesthetic.
Brain abscesses are usually drained by neurosurgeons. Thoracic surgeons drain abscesses in the lung. Otolaryngologists drain abscesses in the neck. These procedures are performed in a hospital operating room. General anesthesia is used.
I have been having a probem with 2 abscesses and a fistula. I'm at the tail end of this painful ordeal. I'm not sure what can be done regarding 2 small cavities in the anus that developed.
Stool collects there often causing pain and discomfort. I have to manipulate it out of the area.
Could you tell me what could be done to correct this probem? I would be happy if the operating team could clean the area and use crazy glue at this point and time. I heard they are using it at time with other procedures. No staples, and stitches. Please let me know. I have not been able to find any info regarding this online.
An abscess has formed on my breast after I stopped breast feeding. I breast feed for a week then had to stop because it was painful, i then started back up with a pump but because i thought i could take care of mastitis on my own an abscess formed. This all happend in 3 weeks. Anyways the abscess had popped yesterday while i was waiting in the hospital to get it drained. I was sent home and told to keep a warm damp cloth on it an make sure i let it keep draining. While in the hospital it drained so much, it was a very light green color. When i got home from the hospital i let it drain some more, but less and less came out. A little more green then it turned to a brownish redish color, then to a dirty clearish color, now watery like blood comes out. How do i know when its all drained? Does the watery blood mean everything is out and is ready to be healed?
thanks kelly
A female family member had a abscess surgically drained on the outside of her labia.It has been days,she has a small open incision and is longer draining,but continuous to c/o pain and surrounding skin is red and swollen,Is this normal after post-op surgical removal of the abscess?
just wondering if i need to leave the padding on whilst showering or it doesnt matter if water can get into the tube . ?
doctor hve give me a antibiotics again now what this all again? why it is paining me?
Cultures still reflect negative, which is a good thing.
Altough, MRI w/contrast nots the following:
Fluid collection which is hypointence on the T1-weighted scans centered to the right of midline in the paraspinous soft tissues and subcutaneous fat extends from the C5-6 level to the T5 level as before. This fluid collection is of uncertain nature. It may represent a seroma, but coud also represent an abcess. An extensive are of abnormal enhancement is presentin the posterior soft tissues of the lower neck and back within the laminectory defects and about this fluid collection and beyond them. This abnormal enhancement is probably in part due to postoperative change, but could also in part be de to inflamation and possibly an infection. Abnormal enhacement is also present in the face joints and facets at the Tl708 levekl and may be due to infection of these facet joints. This enhancement is of uncertain nature but could cionceivably be due to infection of one or more of these joints. Persistent fluis collection centered to the right of midline in the paraspinous sot=ft tissues and subcutaneous fat exteding from C5-6 level to the TF level which may be due to seroma but which could also be due to an abscess. Exxtensive area of abnormal enhancement of the soft tissues of the posterior lower next and back which is probably in part due to postoperative change but which could also be due to inflamation and possibly infection. Enhancement of the facet joints at the T-8
FOR REVERSAL OF THE STOMA WILL THIS DISCHARGE CAUSE ANY SUBSEQUENT SURGICAL PROBLEM? WOULD BE GRATEFUL FOR YOUR REPLY. THANKS.
Please provide me with some advice and assistance.
Thanks
IT IS LOCATED ON MY UPPER RIGHT LEG, BELOW MY BUTTOCKS ON THE SIDE OF THE LEG.
IT IS SO UGLY AND DISGUSTING.
I HAVE BEEN TAKING CEPHALAXIN EVERY SIX HOURS AND THE PUS IS GONE, BUT WHAT REMAINS IS A SMALL HOLE.
I WANTED TO KNOW HOW IT WILL HEAL AND CLOSE OFF OR DO I NEED STITCHES.
I DO NOT KNOW WHAT TO DO.
PLEASE HELP.
THANK YOU.
HPS
Thank you
Linda
d it would cause a fistula. Still oozing 4 months later. Is this normal???.
d it would cause a fistula. Still oozing 4 months later. Is this normal???.
Please help with how i can remove this stuff without hurting myself cause it hurts to tug hard
, thanks
THE PUS IS GONE, BUT WHAT REMAINS IS A HOLE.
I WANTED TO KNOW HOW IT WILL HEAL
plz reply me
Surrounding skin is red and swollen. It is normal? I wanted to know hou it will heal and. and close of or doi need stitches in a big hole.
I was wondering if you could help me.
Thak you.
Should I go for another draining procedure to stop bleeding from that area.
Am concerned about if it is open , I may get infected in future and that may have chances to lead to cancer it seems , and sex also may not possible.
Please suggest me what to do
wide and 6inches long on his back. They made 3 incisions on each side of his back in order to pack and drain it. He also is a diabetic. Is it wise
for me to be concerned? He has to have care every week.
How long time can it go from a fall trauma with a hematoma abscess in the upper leg outside of femoris, when the hematoma is squeezing against the ischiasnerv and make the patient paralyzed from the hip down, to make a drainage of the hematoma abscess? Dr tells its to late to do the drainage, and I wonder when they could have done it. Also what scans, mr, tests could thay have taken to fully detect this huge hematoma in the upper leg on the outside (right side).
Thank you for good info.
Best regards
Sandra lundh
Please help please reply
I had an abcès drain on my left breast and it’s been 2weeks and I’m still bleeding from the abcès drain wound but it doesn’t hurt or anything. WhAt should I do? Please help
I will like to know if its normal to still drain pus after a month.
Thanks
I feel the antibiotics he prescribed was not strong enough.
Can you suggest some good antibiotics though?
Also, he took a scan and said it was nothing serious is it really true its nothing serious?