Abscess Incision and Drainage

Skin abscesses can vary in size and severity. Some smaller abscesses may naturally drain without the need for treatment. If they are larger or persistent, you may be prescribed a course of ‘broad spectrum’ antibiotics to help clear the infection and keep it from spreading. The broad-spectrum antibiotics are designed to help identity specific bacteria so an exact antibiotic can be given.

This may not be enough to treat the problem and the pus will need to be drained.

Incision and Drainage

If your skin abscess needs draining, it is likely you will need a small operation carried out under anaesthetic, usually a local anaesthetic in which you remain awake and the area around the abscess is numbed.

In this procedure, the surgeon makes a cut, (incision) in the abscess allowing for the pus to drain out. A sample will be taken to be tested.

Once the pus has been removed, the hole will be cleaned with sterile saline. The abscess is left open but covered with a wound dressing, allowing for any extra pus produced draining away easily. If it is a deep abscess, antiseptic dressing (gauze wick) may be placed inside the wound to keep it open to allow for further draining.

Internal Abscesses

If the abscess is internal the pus will usually need to be drained by using a needle that is inserted through the skin (percutaneous abscess drainage) or with surgery.

The method used is dependent on the size and location of the abscess. Antibiotics will also be given at the same time to help kill the infection and prevent spreading.

Percutaneous Drainage

If the internal abscess is small, the surgeon may drain this with a fine needle. Based upon the location of the abscess, the Consultant will determine whether a general or a local anaesthetic will be used to complete the procedure.

The surgeon may use ultrasounds or computerised tomography (CT) scans, as an aide to guide the needle into the right place. After this location process, a small incision will be made over the abscess with a draining catheter put in place to drain the pus into a bag, this will remain in place for a week to drain fully.

This procedure may be carried out as a day procedure meaning you may be able to go home the same day; however, some people may have to stay in for a few days.

Surgery

If the internal abscess is too large to be drained with a needle, or for other reasons a needle cannot get to the abscess safely, surgery may be necessary This will generally involve using general anaesthetic  and the surgeon will make a larger incision in your skin to allow the pus to be washed out.