Incision and drainage (I&D) of an abscess

Category: Minor Procedures, Injections & Pain Relief · All minor procedures, injections & pain relief

What it is

Incision and drainage (I&D) opens a skin abscess — a walled-off collection of pus — and lets it drain. It is the main treatment for a formed abscess; antibiotics alone usually cannot penetrate the pus collection.

Why it is done

Indications include painful, fluctuant (soft, wobbly) lumps — commonly boils, perianal abscesses, pilonidal abscesses, and infected cysts — once a collection has formed, shown by examination and sometimes ultrasound.

How to prepare

You will be examined; diabetes and immune status are noted. Local anaesthetic (sometimes sedation or general anaesthetic for large, deep or perianal abscesses) is planned. Blood thinners are reviewed. No fasting unless sedation or general anaesthetic is planned.

What happens during the procedure

After numbing, the abscess is opened with a cut, pus is drained (and usually cultured), the cavity is gently probed and washed out, and sometimes packing or a small drain is placed to keep it open while it heals from the inside. It takes about 15 to 30 minutes.

Afterwards — recovery & results

Wounds are usually left open to heal gradually ('healing by secondary intention') with dressings and sometimes salt-water soaks; you will be shown how to care for them. Pain usually improves quickly once pressure is relieved. Seek help for spreading redness, fever or worsening pain.

Risks & considerations

Risks include bleeding, recurrence (common if the cavity closes too early — hence packing and dressings), infection spread, and scarring. Large or recurrent abscesses may need surgical review to find an underlying cause.

Frequently asked questions

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