Incision and Drainage of an Abscess

This leaflet will tell you what happens when you have an incision and drainage of an abscess.

What is an incision and drainage of an abscess?

The most common reason for incision (cut) and drainage is to treat an abscess. An abscess is a collection of pus surrounded by a red and inflamed area of tissue.

The reason an incision and drainage will be performed is to release the collection of pus from the body.

This will help to treat the abscess and relieve pain which may be caused by the inflamed area.

Abscesses can be formed when the skin is invaded by microorganisms (bugs). Cellulitis (a type of skin infection) may happen before or happen at the same time as an abscess.

What causes an abscess?

Most abscess are caused by a bacterial infection. When bacteria enters your body, your immune system sends infection fighting white blood cells to the infected area.

As the white blood cells attack the bacteria, some nearby tissue dies, creating a hole which then fills with pus to form an abscess. The pus contains a mixture of dead tissue, white blood cells and bacteria.

Although skin abscess can be present anywhere on the body they are more common in some areas:

•           Underarm
•           Torso
•           Genitals
•           Buttocks
•           Groin

Often if an abscess is caught early enough antibiotics can be given which may help prevent the abscess from developing.

Sometimes the abscess will burst by itself and at this point no operation would be required.

However, if the abscess has already formed then an incision and drainage procedure may be required. Your clinician would make this decision after discussing the options with you.

Who can get an abscess?

Anyone can get an abscess from children to adults.

Symptoms of an abscess

•          Bleeding
•          Redness
•          Pain
•          Swelling
•          Inflammation
•          Discharge (pus) – which often smells
•          A visible build-up of white or yellow pus under the skin in the affected area
•          Tenderness to touch
•          High temperature

Are there any risks or possible complications?

These risks are applicable to any minor or major surgery: 

• Bleeding – Bleeding from the operation site can happen for up to 1 week.  If this bleeding continues and shows no signs of stopping you may need further treatment.

• Infection – Signs of an infection include generally feeling unwell, with a temperature or a very smelly discharge from your wound. This can be treated with a course of antibiotics and you may need a longer stay in hospital.   

• Pain – You may experience pain following your operation in which case you will be given pain relief to take on discharge. Local anaesthetic may be given at the time of the operation to help for the first few hours following your operation. 

• Recurrence (happening again) – If this happens you may need further treatment or another operation.

• Wound healing – this may be a prolonged process and take time to heal.

Acute symptoms 

Antibiotics may be given if you show signs of an infection before surgery. Antibiotics treat a wide range of bacteria and help to give relief from infection and discomfort. Painkillers and inflammatory medications can be taken to help reduce pain.  

What do I need to do before the operation?  

Routine blood tests may have been done on admission, but if not they will be done before your operation.

You will be given some anti-embolism stockings ‘TED stockings’ to wear before, during and after the operation, this is to help prevent blood clots forming in your legs. Patients often wear flowtron boots which are applied on the lower legs in surgery to help stimulate the flow of blood through the deep veins. These will be removed when you are awake and you can mobilise again safely.

Why am I asked not to eat or drink before my operation?  

Your Nurse will tell you when you must stop eating or drinking before your procedure. This is very important.

If your stomach contains food or drink during your operation, this can get into your lungs, affect your breathing and cause an infection.

You must follow the instructions, but if you do forget you must tell your doctor or Nurse, as your procedure may need to be postponed for your safety.  

What will happen during my operation?  

Your theatre nurse will check your details again before taking you into the anaesthetic room.

In the anaesthetic room you will meet your anaesthetist again; a cannula (fine needle) will be placed in the back of your hand or arm so we can inject medications. Sometimes, when medicines are injected they may feel cold and sting a little. 

An intravenous drip may be attached to your cannula. Your blood pressure will be measured. Your pulse will be taken, and the amount of oxygen in your blood will be measured by attaching a special clip to your finger.

Your heart rate will be monitored by placing sticky pads on your chest. These are attached to some leads to show a tracing of your heart on a monitor. This is routine and nothing to worry about. 

The operation may be carried out under a general anaesthetic (a state of carefully controlled and supervised unconsciousness that means you are unable to feel any pain), a spinal anaesthetic (which may mean you are awake or asleep), or a local anaesthetic (where the area operated on is numbed but you are awake). Your anaesthetist will explain this in more detail before the surgery.

What will happen after the operation?  

You will be taken to the recovery room. Specially trained nursing staff will look after you until you are ready to return to your ward or be discharged. 

If at any time you are in pain or feel sick, please let one of your nurses know and they will give you medication to help relieve it. 

You will have an intravenous drip in your hand or arm through which you will receive fluids to prevent you from dehydrating until you are able to eat and drink normally again. 

What to expect after the operation  

You may experience some discomfort following this procedure when the local anaesthetic wears off depending on the outcome of the operation. Analgesia (pain relief) will be prescribed to take home.

For the next few weeks avoid putting pressure on your wound to try to help the healing process of the wound site.

Please follow these instructions; 

• Keep the area clean and dry.   
• Do not apply any creams or ointments, unless they have been prescribed by your surgeon. 

How long will I be in hospital?  

Every patient is different and recovers at different speeds. This operation can normally be done as a day case procedure. 

However, if a wider excision is needed this might mean a longer stay.

If you have any medical conditions that need to be monitored post operatively then you may be asked to stay in hospital for 24 hours for observation.

It is important to try and be mobile as soon as you feel safe to do so and hygiene is important to try and prevent any infection. You are able to take a shower the day after the procedure.

Will I have any sutures (stitches) to be removed?  

You will be given advice after the operation and instructions to follow if you require any sutures to be removed.

How long will I need to be off work?  

This may depend upon the type of work you do. You should ask your Doctor or GP for advice.Your consultant will send a discharge letter to help advise your GP.

If you are taking any medication that makes you drowsy, you must not drive or operate machinery.  

You should try to avoid any activity that may pull at the wound area. You should only do what you feel able to do and give your body time to heal.

If you require a ‘Fit note’ for work please let a member of staff know before you are discharged from hospital. 

What should I look out for at home?

When you go home, if you notice any of the following or are worried about the wound: 

Signs of: 

• Infection
• Redness
• Swelling
• Pain
• Heat
• High Temperature
• Bleeding from the wound site
• Pus or an unpleasant smell coming from the wound site.

You must contact the Surgical Decisions Unit if any of these symptoms occur in 7 days after discharge. After 7 days contact your GP.  

How can I help myself?  

You will probably be more comfortable wearing loose fitting clothes over the wound site.

When can I drive again?  

You should ask your consultant/surgeon for advice on this matter as it could change depending on the location of your abscess.

You should check with your insurance company as policies may vary with individual companies. 

When can I play sport again?  

You should not go swimming until the area has healed and only do light sport activities. This will help in the healing process.

Will I have a follow up appointment?   

You will not normally have a follow up appointment after the operation. Dressing (elastoplast or bandaging) information will be given at discharge, and if further input is needed you will be asked to go to your GP.

Contact numbers   

If you have any worries or concerns during the first 24 hours following your discharge from hospital, please phone the ward to which you were admitted.  

After 24 hours; please seek advice from your GP.  

North Tees and Hartlepool NHS Foundation Trust

University Hospital of North Tees

Ward 28  

Telephone: 01642 382828  

24 hours a day, 7 days a week  

Ward 31  

Telephone: 01642 382831  

24 hours a day, 7 days a week  

Day Case Unit  

Telephone: 01642 624168  

Monday to Friday 8am to 5pm

University Hospital of Hartlepool

Ward 9  

Telephone: 01429 382809  

24 hours, 7 days a week  

Day Case Unit  

Telephone: 01429 522949  

Monday to Friday 8am to 5pm  

Non-urgent messages can be left on the answering machine  

For Urgent advice within 1 week of discharge, please contact:  

Surgical Decision Unit 

24 hours a day, 7 days a week 

01642 617617 – ask switchboard to contact the SDU coordinator on extension 46430 or via Vocera. 

NHS 111 offers medical help and advice from fully trained advisors supported by experienced nurses and paramedics. Available over the phone 24 hours a day contact 111. 

NHS Choices provides online information and guidance on all aspects of health and health care, to help you make choices about your health. W: www.nhs.uk  

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