# Abscess Incision and Drainage

## Overview

This module describes how to identify and manage an abscess where incision and drainage is indicated.

## Indications

## Contraindications

## Patient information and consent

Always verify your patient’s identity and obtain informed consent before proceeding.

### How do I explain this procedure?

“This skin infection is called an abscess or boil, which must be cut open to allow the pus inside to run out, before the area can heal.”

### What can my patient expect?

“I will give you an injection for pain, first. Then I will make a small cut and clean out the pus.”

### What is my patient’s role?

“Let me know if you have any allergies, a heart condition, or a bleeding tendency, or use blood thinners. Fearing blood or needles is normal, but tell me if you have fainted from it. Keep as still as possible. If you feel strange sensations like tingling or severe pain, tell me immediately.”

## Preparation

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### Documentation

### Equipment

## Site and Positioning

Position the patient supine or reclining with the abscess within easy reach. When making the incision, incise along

Langer's lines

Langer's lines

of skin tension.

## Procedure

Follow medical asepsis with sterile gloves; however, due to the nature of abscesses, complete sterility may not always be achievable.

## Troubleshooting

I’m not sure whether this is an abscess or not.

To distinguish between cellulitis and abscess, use ultrasound to check for a dark collection of fluid contents under the point of maximum fluctuance/erythema and swelling.

My patient gets recurring abscesses.

After incision and drainage, take a deep swab and send for microbial culture and targeted antibiotics. For repeated axillary abscesses, refer to dermatologist to exclude hidradenitis suppurativa.

## Risks

## References