Abscess Incision & Drainage

An abscess is a walled-off collection of pus. The abscess can originate from an obstructed hair follicle or sweat gland, or can occur due to an abrasion (such as shaving) or a break in the skin. Common locations for abscesses include the armpit, the back, the vaginal labia, areas of hair growth, the gums, and sites of needle injection.

Symptoms and home treatment

Initially, an abscess begins as a small, tender, warm, red swelling. If the swelling is smaller than ½ inch (or 1cm), the application of warm, wet compresses for 15-20 minutes, applied several times over the course of 24 hours and followed with the application of topical antibiotic ointment, may be enough to open the pores of the skin and facilitate healing. Healing would be noted by a decrease in the size of the swelling and the eventual absence of pain and redness.

However, these infections tend to wall themselves off from our blood supply and immune system. This allows the organisms within to multiply, unhindered by our natural defenses. The swelling enlarges and becomes more extensive and tender.

Risks

As the abscess enlarges, the pus cavity swells. Occasionally, multiple cavities will form. The surrounding skin can get very red and hot; a fever may or may not be present. As with all infections, there is risk of the organisms entering the blood stream and thus placing the entire body at risk of infection – both local structures and distant tissues including blood, bone, brain, heart. The likelihood of complications may be increased with certain medical conditions such as diabetes, hepatitis, or with the use of chronic steroids.

Treatment

The treatment of an abscess involves local numbing of the area, followed by incision and drainage of the pus contained inside. The abscess cavity is usually packed with a wick to keep the cavity open and allow drainage of any remaining pus within. For a straightforward abscess, this is the definitive treatment, and the patient will be asked to return in 48 hours for re-check of the site and removal of the wick. If the skin surrounding the abscess is very red and hot, oral antibiotics may be prescribed. Tetanus status should be reviewed and updated as needed.

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