Drainage of an abscess or haematoma

What is this?

Surgical incision and drainage of an abscess or haematoma

What alternatives are there?

Aspiration under X-ray control, drainage under X-ray control, prolonged antibiotic treatment, observation

What to expect before procedure

You will sometimes have been admitted to hospital as an emergency for this condition. If surgery is required on an elective basis, you will normally be admitted on the day of surgery. If earlier admission is required, a pre-clerking appointment will be sent to you to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and your named nurse. A pre-medication will normally be prescribed by the anaesthetist 1-2 hours before the surgery; this will make you dry-mouthed and pleasantly sleepy.

What happens during the procedure?

Normally, a full general anaesthetic will be used and you will be asleep throughout the procedure. In some patients, the anaesthetist may also use an epidural or spinal anaesthetic which improves or minimises pain post-operatively. An incision is normally made directly into the abscess or haematoma. This involves either re-opening the original incision (If there has been one) or making a new incision over the abscess/haematoma. Once the abnormal material has been drained, it is common for a small drainage tube to be inserted to prevent re-accumulation. This drain may need to remain in place for up to a week. In some situations, a pack is inserted instead of a drain.

After the procedure

You may experience discomfort for a few days after the procedure but painkillers will be given to you to take home. Absorbable stitches are normally used which do not require removal. It is usual to remove the drain before you go home. However, under certain circumstances, the drain may need to stay for a little longer. You will, in this situation, be given an appointment to attend the ward either to remove or to shorten the drain. This prevents re-accumulation of the blood or infection and allows the cavity to heal from its depths towards the skin. The average hospital stay is 5 days.

Potential side effects