Incision and Drainage

What is Incision and Drainage

Incision and drainage is a surgical procedure to open and drain a fluid-filled sac. The sac may be filled with pus, mucus, or blood. Examples of fluid-filled sacs that may need surgical drainage include cysts, skin infections (abscesses), and red lumps that develop from a ruptured cyst or a small abscess (boils).

You may need this procedure if the affected area is large, painful, infected, or not healing well.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.
  • Bleeding.
  • Allergic reactions to medicines.
  • Scarring.

What happens before the procedure?

  • You may need an ultrasound or other imaging tests to see how large or deep the fluid-filled sac is.
  • You may have blood tests to check for infection.
  • You may get a tetanus shot.
  • You may be given antibiotic medicine to help prevent infection.
  • Follow instructions from your health care provider about eating or drinking restrictions.
  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
  • Plan to have someone take you home after the procedure.
  • If you will be going home right after the procedure, plan to have someone stay with you for 24 hours.

What happens during the procedure?

  • To reduce your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • Your skin will be washed with soap.
  • You will be given one or more of the following:
    • A medicine to help you relax (sedative).
    • A medicine to numb the area (local anesthetic).
    • A medicine to make you fall asleep (general anesthetic).
  • An incision will be made in the top of the fluid-filled sac.
  • The contents of the sac may be squeezed out, or a syringe or tube (catheter) may be used to empty the sac.
  • The catheter may be left in place for several weeks to drain any fluid. Or, your health care provider may stitch open the edges of the incision to make a long-term opening for drainage (marsupialization).
  • The inside of the sac may be washed out (irrigated) with a sterile solution and packed with gauze before it is covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
  • Do not drive for 24 hours if you received a sedative.

Incision and Drainage, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

  • Pain or discomfort around your incision site.
  • Drainage from your incision.

Follow these instructions at home:

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
  • Follow instructions from your health care provider about:
    • How to take care of your incision.
    • When and how you should change your packing and bandage (dressing). Wash your hands with soap and water before you change your dressing. If soap and water are not available, use hand sanitizer.
    • When you should remove your dressing.
  • Do not take baths, swim, or use a hot tub until your health care provider approves.
  • Keep all follow-up visits as told by your health care provider. This is important.
  • Check your incision area every day for signs of infection. Check for:
    • More redness, swelling, or pain.
    • More fluid or blood.
    • Warmth.
    • Pus or a bad smell.

Contact a health care provider if:

  • Your cyst or abscess returns.
  • You have a fever.
  • You have more redness, swelling, or pain around your incision.
  • You have more fluid or blood coming from your incision.
  • Your incision feels warm to the touch.
  • You have pus or a bad smell coming from your incision.

Get help right away if:

  • You have severe pain or bleeding.
  • You cannot eat or drink without vomiting.
  • You have decreased urine output.
  • You become short of breath.
  • You have chest pain.
  • You cough up blood.
  • The area where the incision and drainage occurred becomes numb or it tingles.
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