Hospitals drain abscesses primarily through incision and drainage (I&D), where a cut is made to release pus, or via percutaneous drainage, using imaging to guide a needle or catheter to drain it, often with local anesthetic, but general anesthesia for larger or deep abscesses, leaving the opening to heal from the inside out. A sample of the pus is often sent to a lab to identify the infection.
Treating an abscess
You can usually have the procedure with a local anaesthetic medicine. This means that you do not feel any pain during the surgery.
The doctor will make a very small skin incision at the site. After the patient is sedated for the procedure, the interventional radiologist uses image-guidance to place a catheter (a long, thin, hollow plastic tube) through the skin and into the abscess to allow for drainage of the infected fluid.
Abscess incision and drainage are considered minor surgery. In most cases, you will remain awake and receive only a local anesthetic to numb the area around the abscess before the procedure. The incision and drainage can take place in your doctor's office.
Now it is possible to drain abscesses by inserting a fine plastic tube, called a drainage catheter, into it through the skin, with only a tiny incision. This procedure is called Percutaneous (through the skin) abscess drainage.
The operation usually takes 10 to 20 minutes. Your surgeon will make a cut on your skin over the abscess. This allows the pus to drain out. Once the pus has been removed, the cavity needs to heal upwards from the inside out, so the opening in your skin is left open.
Contraindications to Incising and Draining an Abscess
Abscesses close to major neurovascular structures (eg, the axilla, antecubital fossa, posterior knee, groin area, neck) Abscesses that are difficult to adequately expose or explore because of location (eg, perirectal abscess)
A doctor or advanced clinical practitioner has diagnosed you with an abscess. You need a day case surgery to drain the infection. You will have a general anaesthetic for the surgery. This will make you sleep during the surgery.
If you're still seeing swelling, pain, or pus after several days, or if symptoms return after improving, it could mean the abscess isn't healing. You might need a different antibiotic or a second look to see if deeper drainage is necessary.
To start, make a small incision at the periphery of the area of induration or abscess pocket with a #11 blade scalpel. Then insert a hemostat and break up any loculations as with the classic method. With the hemostat still inserted, use the tip to tent the skin on the opposite edge of the abscess cavity.
Drainage Stage: If the abscess reaches a point where it can no longer contain the infection, it may drain naturally or require medical intervention to drain the pus. This stage helps relieve pressure and reduce the risk of the infection spreading. The area may remain tender as the pus is released, and healing begins.
Wet to Dry Dressings:
Three times a day remove bandages and clean the wound. You may shower at this time. Gently clean out all loose debris with a Q-tip or washcloth. If your wound is not draining much, moisten a piece of gauze with saline, and gently place gauze into the deepest part of the wound.
This retrospective data suggests that abscesses greater than 0.4 cm in depth from the skin surface may require a drainage procedure. Those less than 0.4 cm in depth may not require a drainage procedure and may be safely treated with antibiotics alone.
The standard treatment for an abscess is an abscess incision and drainage (I&D). During this procedure, the general surgeon will numb the surface of your skin, and an incision will be made to drain any debris, which helps relieve pain and speed healing.
Avoid strenuous activity for the next eight hours in order to prevent excess bleeding. 3. Your wound may continue to drain a large amount over the next several days as the infection slowly heals. You may apply gauze dressing to the wound to protect your clothing.
Treatment. You can apply moist heat (such as warm compresses) to help the abscess drain and heal faster. Do not push and squeeze on the abscess. Your provider may cut open the abscess and drain it.
How long does incision and drainage take to heal? After an abscess has been treated it can typically take about 2-3 weeks to completely heal, but most people can return to normal activities after a few days.
An abscess forms when your immune system walls off an infection, usually bacterial (like Staph), creating a pocket filled with pus (bacteria, white blood cells, dead tissue) that can't drain, often entering through cuts, follicles, or blocked glands. While bacteria are the main culprit, fungi, parasites, or blocked ducts can also cause them, leading to painful, swollen, red lumps, and sometimes deeper internal abscesses from surgery or existing conditions.
Abscesses can develop relatively quickly - as little as one or two days after the first signs of infection. They may progress undetected and therefore untreated, and develop for months or even years.
Signs of a skin abscess can include:
You might wonder, “What will the ER do for an abscessed tooth?” or “Can a hospital drain a tooth abscess?” In some cases, yes, an emergency room provider may be able to drain an abscess, depending on its location. Go to the ER right away if you have an abscess and any of these symptoms: Fever. Swollen face swelling.
The pain can get worse when you lie down. You may find it hard to sleep. In severe cases, you may find it hard to open your mouth and swallow. You may also have difficulty breathing.
Risks may include infection or bleeding, and while rare, it's possible for nearby organs to be damaged. Your care team will speak with you about the risks of the procedure and the steps they will take to minimize these complications.
Warning Signs of a Persistent Infection
Swelling Increases or Spreads: Swelling that doesn't improve, gets larger, or spreads to other parts of your face or neck. Foul-Smelling Discharge: Persistent, bad-smelling, or discolored drainage from the abscess location.
Your doctor may test for MRSA and prescribe antibiotics directed at treating these particular bacteria. Sometimes an abscess is not ready to be drained, which means that it is not yet organized into a defined pocket. Antibiotics may be effective at treating this infection and prevent it from becoming an abscess.