Abscess Removal Surgery , Procedure And Aftercare

An abscess is an abnormal collection or buildup of pus (a thick yellowish-white fluid caused by an infection of white blood cells, germs, and dead tissue) within a confined area (pocket of pus), that can form anywhere in your body. An infection in your body causes an inflammatory response by the white blood cells (WBCs) when your immune system tries to fight the infection. This leads to the accumulation of pus within the damaged tissues. An abscess can cause severe pain, and the skin around the abscess looks inflamed and may appear red, raised, and swollen. 

Usually, small abscesses resolve independently; however, if they don't, your surgeon can prescribe antibiotics to treat the bacterial infection that may cause the abscess. Large abscesses that cause severe pain and discomfort can be managed through surgical drainage (incision and drainage) where the abscess is punctured to drain the pus. 

Read on to know more about abscess surgery, how it is performed, its benefits, and the potential risks involved.

An abscess surgery is a procedure used to treat an abscess and is also known as “Incision and Drainage (I & D),” which drains the pus accumulated within the affected area. These minor surgical procedures effectively help release the increased pressure buildup in the abscess.  It is recommended for large or persistent abscesses that do not clear up through antibiotic therapy.

An abscess surgery (incision and drainage),  performed by a skilled surgeon, is a safe procedure without any serious post-op complications. Preparation before the procedure is as follows:

• Your surgeon will conduct a physical exam to check the size, extent, and depth of the abscess and will evaluate your symptoms.
• You should inform your surgeon about your medical history to rule out pre-existing conditions like diabetes (increased blood sugar levels),  hypertension (high blood pressure), or any blood disorders that may negatively impact your healing and recovery process.
• Keep your surgeon informed about your medication history, drug allergies, and previous surgeries.
• Your surgeon may advise blood tests such as blood culture to identify the cause of the infection to determine the antibiotics to be prescribed.
• You will be asked to discontinue medications like blood thinners, etc., and other herbal supplements 2 weeks before the procedure to prevent the risk of bleeding during and after the procedure..
• You must avoid alcohol for 24 hours before the surgery, which may delay the wound healing.
• You may be started on a course of antibiotics to help treat the infection and prevent any further infection post-surgery.
• If the surgery is performed under general anesthesia, you may be advised to fast 6 to 8 hours before the abscess surgery.
• You should arrange for a family member to drive you home after surgery as you cannot drive due to the effect of anesthetic drugs.

An abscess surgery is a minor procedure that usually does not require hospitalization, but sometimes you may require an overnight hospital stay if the abscess is large and severely infected, or if you suffer from other pre-existing conditions (diabetes, etc.). The procedure is as follows:

• You will be taken to an operating room where your surgeon will administer either local or general anesthesia (numbing solution to sedate you), depending on the severity of the condition.
• The area to be treated will be cleaned with an antiseptic solution to remove any surface contaminants.
• An incision (cut) will be made over the skin of the abscess with a surgical blade (scalpel).
• Pressure will be applied over the cut wound to drain or squeeze the pus completely from the abscess.
• The drained pus will be collected and sent to the laboratory to evaluate further the organism causing the infection.
• The wound will then be thoroughly cleaned using a saline solution to remove any remaining debris.
• The wound should be left open and not closed through sutures; a sterile gauze or bandage is used to pack the wound to allow further drainage. This will also allow healing from the inside out.
• A waterproof surgical dressing will be placed over the packed wound for protection. 
• The entire procedure takes around 30 to 60 minutes, depending on the severity of the abscess. 

You will be kept in a recovery room for an hour or two until the effect of your anesthesia wears off, and then you are allowed to go home. However, if the abscess is large and severely affected, you may be kept overnight in the hospital for observation. 

• Immediately after the procedure, you may experience mild pain and discomfort, which is normal and easily managed through pain medications.
• A catheter (thin tube) may be secured to the wound for further drainage for large abscess wounds.
• Once you are back home, rest well for a day or two post-surgery.
• You may shower after a day; however, avoid hot tub baths and do not soak the wound to prevent infection.
• Change your dressing every day to promote quick healing and faster recovery.
• Continue the antibiotics and pain medications prescribed by your surgeon.
• Avoid spicy and fried foods, citrus fruits and juices, and caffeinated drinks for at least 1 week.
• Avoid lifting heavy objects and strenuous exercises for at least 1-week post-surgery.
• Recovery may take around 4 to 6 weeks for the wound to heal completely from the inside out.

Removing the abscess has many advantages and poses a high risk of infections and other complications if not treated on time.

Benefits

• An abscess surgery helps you eliminate the chronic (long-lasting, persistent) pain caused by the infected abscess.
• It provides a permanent solution since the abscess is completely drained to remove pus, and recurrence is rare.
• It provides good accessibility and visibility to the surgeon, unlike other alternative treatment methods

 Risks 

• Wound infection may cause pain, discomfort, or pus discharge from the surgical site.
• Hematoma formation (bleeding under the skin at the surgical site that may cause swelling).
• Mild scarring at the incision site.
• Recurrence of the abscess in the same area or elsewhere in the body.
• Damage to the nearby nerves may cause numbness in the affected area.
• Allergy due to the anesthesia causing skin rash, hives, dizziness, confusion, or shortness of breath.
• Formation of blood clots that may get dislodged into the bloodstream and travel to internal organs like the lungs (pulmonary embolism), causing life-threatening complications.

Though incision and drainage is a safe and highly effective procedure to drain an abscess, some possible alternative non-surgical methods may help, including:

• Warm compression 
  A warm compress using a warm towel or gauze can naturally drain the abscess, however, do not attempt to burst or squeeze the abscess. This may reduce the swelling and speed up recovery.
• Antibiotics
  Once the causative organism is identified with the help of blood culture, your doctor may prescribe the appropriate antibiotics to help treat the infection, which can eventually reduce the size of an abscess. 
• High-intensity focused ultrasound (HIFU)
  It is a non-invasive method that uses sound energy to help reduce the size and severity of the abscess with the help of an ultrasound device. This is gaining momentum since it aids in faster healing with minimal postoperative complications, no incisions or scars, and no drainage catheter is required. 

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!