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Emergency Department Discharge Instructions

Abscess - incision & drainage

Emergency Care Discharge Instructions

Instruction summary

An abscess can occur when bacteria gain entry to the skin, either from a cut, a bite, or even very thin skin (which can have tiny tears in it). The bacteria multiply and a ball of pus forms under the skin, with walls around the pus that may prevent antibiotics from getting into the abscess. If it is a small abscess, sometimes called a boil, antibiotics may be able to treat the abscess. If it is large, however, the abscess usually needs to be cut open in order to drain, and it must remain open and draining for a few days or more.

If it was opened and drained (called “incision and drainage”) in the ER, it is likely that some ribbon gauze (also called “packing”) was tucked inside the wound, to prevent the skin from resealing shut (and the pus recollecting inside all over again). If it is covered in pus and blood, that is good, because it means that the abscess is draining well. You can pull the dirty gauze out, and gently tuck a fresh strip of ribbon gauze (use one-quarter inch width ribbon gauze for most abscesses, which you can buy at a drugstore) inside the wound. Gently tuck in more gauze until the hole is filled, but not filled tightly. Make sure some gauze is left sticking out of the wound (so that you can pull it out in a few days).

After 2-3 days, you can either pull out the gauze and leave it out, or put in a new strip of ribbon gauze (a fresh packing change), depending on what the emergency physician told you to do. If it was a large abscess it may need several packing changes every 2-3 days, but if it was small it may not need any packing changes.

Take all your antibiotics if you were prescribed them – don’t stop early.

Reasons to return to the ER
  1. Increasing pain
  2. Worsening redness or a red streak going up your arm or leg
  3. Fever (≥38.0 °C or 100.4 °F)