Goals

Incision and drainage of superficial abscesses promotes drainage of bacteria, necrotic tissue, and toxins. The procedure decreases pain due to pressure and the incidence of systemic illness.

Background

Abscesses are localized infections of tissue marked by a collection of pus surrounded by inflamed tissue. Abscesses may be found in any area of the body; those requiring more urgent attention are found on the extremities, face, buttocks, breast, perianal area, axilla, and groin.

Abscesses begin when the normal skin barrier is breached, and microorganisms colonize the underlying tissues. Causative organisms commonly include Streptococcus sp., Staphylococcus sp., enteric bacteria (perianal abscesses), or a combination of anaerobic and gram-negative organisms.

Smaller abscesses may resolve with conservative measures (warm soaks) to promote spontaneous draining. Larger abscesses will require incision to drain them as the increased inflammation, pus collection, and walling of the abscess cavity diminish the effectiveness of antibiotic treatment.

Contraindications

• Extremely large abscesses or deep abscesses in areas that are difficult to anesthetize
• Cutaneous cellulitis without an underlying abscess
• Abscesses involving areas of the body for which there are specific cosmetic concerns, such as the face or breast