d. Anesthesia. Follow this procedure:
Infiltrate 0.5 percent or 1 percent lidocaine into the incision site over the
(2) Anesthetize the area well beyond the incisional area so that drainage
can occur without the hindrance of pain.
(3) Delay the incision for several minutes after the injection to be sure there
is a complete anesthetic block.
e. Procedure. Use this procedure for abscess incision and drainage:
(1) Make a gentle stab wound. To do this, use a number 11 scalpel blade.
Make the stab wound perpendicular to the skin and into the periphery of the abscess
(2) Make a second straight incision. Make this cut to the opposite periphery
of the fluctuant area. This cut must extend across the full diameter of the abscess
cavity to be sure there is complete evacuation of the purulent drainage.
Obtain cultures from the drainage.
(4) Perform intracavity exploration to break up any adhesions. Use a gloved
finger for larger abscesses. For smaller abscesses, soak a cotton-tipped applicator with
hydrogen peroxide. Then, explore the cavity with the applicator to remove all pus,
debris, and sebaceous materials.
(5) Following exploration, clean the cavity with four to six hydrogen peroxide
soaked, cotton-tipped applicators. You may also irrigate the cavity with a sterile saline
(6) Observe the incision for hemostasis. Hemostasis should occur
spontaneously, but may be aided by subsequent packing.
(7) The abscess may be loosely packed using one-fourth or one-half inch
iodoform or plain gauze packing. This helps in keeping the cavity open and permits
(8) Apply a sterile gauze dressing and secure the dressing with
nonallergenic adhesive tape.