| An incision of skin and subcutaneous tissue is the first surgical step performed in order to drain an abscess or cyst. An incision is a cut or a wound produced by cutting with a scalpel. The procedure is usually carried out under local anesthesia.
An abscess is a cavity containing pus (bacteria, white blood cells, and debris from dead tissue cells) and surrounded by reddened (inflamed) tissue. Abscesses of the skin are often caused by staphylococcal bacteria, which invade the skin after it is broken or punctured. Abscesses may also occur in other organs and tissues deeper in the body. Healing of a superficial abscess generally occurs after it has been incised and drained. Individuals with deep abscesses usually need antibiotics in addition to incision and drainage.
A cyst is a closed sac containing fluid or semisolid material that is located under the skin. A common type of cyst is a sebaceous cyst (epidermal cyst), a benign cyst formed from the epidermis (the outermost layer of the skin) or the epithelium (cells lining surfaces of the body) of the hair follicle. Cysts may be unsightly or bothersome and can become inflamed. |
Source: Medical Disability Advisor
| Abscesses are incised and drained when conservative treatments such as hot packs have been ineffective. An abscess must be "ripe" prior to performing an incision and drainage. Ripe means that the abscess is localized, that there is freely flowing fluid inside the abscess (fluctuant), that it is tender, and that it is reddened (inflamed). An incision creates an opening that allows removal of the pus and irrigation of the abscess cavity. If the pus is not drained, an untreated abscess can spread infection to deeper tissues under the skin and even in the bloodstream.
Cysts may be removed (excised) for many reasons. Removal of cysts may be recommended if their appearance has become unsightly, the cysts have become bothersome or painful, they have recurred, an infection has developed, the cysts are enlarging, or if they have produced a foul-smelling discharge. |
Source: Medical Disability Advisor
| The area of the abscess or cyst is thoroughly cleansed with an antibacterial solution, and a local anesthetic is given. For an abscess or an infected cyst, a stab incision is made down to the pus-filled cavity. The small stab incision is then enlarged to allow full drainage of the abscess. The tip of the forceps is introduced into the cavity, and then the jaws of the instrument are opened to improve drainage; additionally, the cavity should be explored to break down all small spaces. Samples of the pus can be obtained for identification of the bacteria responsible for the infection (culture). The contents can also be aspirated (suction) by a tube passed through the incision. After the cavity has been completely drained, it is thoroughly irrigated. The cavity may be packed with gauze containing an antibacterial medication. The exterior wound should be kept open until the cavity heals from within. A dressing is placed over the area. Treatment with antibiotics is unnecessary unless there is evidence of spreading infection or unless the procedure was performed on the hand or face.
For excision of a cyst, two slightly curved, intersecting, parallel incisions are made (elliptical) over the main portion of the cyst. Care is taken not to rupture the cyst. The incisions will be somewhat longer than the cyst, and the skin between the incisions will be removed intact with the cyst. The cyst and its covering skin can then be carefully lifted while gently cutting them away from the underlying tissue (dissecting). Any bleeding that occurs with removal is controlled (with pressure, cauterization, or suturing). The skin is sutured together, and a dressing is applied. |
Source: Medical Disability Advisor
| The predicted outcome is complete healing within 10 to 14 days. Scarring may occur following surgical treatment of abscesses and cysts, although some incisions may heal with minimal or no scarring. The degree of scarring varies, depending on the size and severity of the original lesion, the presence of infection, and how well the edges of the incision were closed together (approximated). The degree of scarring following treatment of small abscesses (those treated before becoming large) is often much less than the scar resulting from larger abscesses that need packing and prolonged treatment. |
Source: Medical Disability Advisor
| Complications may include bleeding and spread of infection. |
Source: Medical Disability Advisor
| Adequate hygienic care of the surrounding skin is necessary to prevent infection. Sometimes dressings over the wound may need to be left in place for a prolonged period of time to protect the wound and to prevent contamination and infection. Employees may be restricted from returning to work areas that may be especially dirty. Alternative, temporary work duties may be needed during recovery. Time off from work may be necessary for recovery and healing of abscesses that have been packed open. Recovery time may be longer if the original abscess or cyst occurred in a location that is subject to stress and strain, such as in the area of a joint. Extra recovery time may be needed to allow adequate healing and return of tissue strength. |
Source: Medical Disability Advisor
| Durkin, Willaim T. "Abscess." eMedicine Consumer Health. Eds. Steven C. Gabaeff, Francisco Talavera, and Anthony Anker. 7 Apr. 2005. Medscape. 20 May 2005 <http://www.emedicinehealth.com/articles/19988-6.asp>. |
Source: Medical Disability Advisor