Abscess Incision and Drainage: What Happens and How to Care for the Wound

By Dr. Rashna Ginwalla, Clearwater Advanced Surgical Associates, LLC

An abscess is a pocket of infection — a collection of pus — that forms under the skin. The body walls it off, which is why antibiotics alone often aren't enough to clear it. The definitive treatment is incision and drainage (I&D): opening the abscess to let the infection out, then letting the wound heal from the inside.

This procedure is typically quick and done in the office or an outpatient setting, often under local anesthesia.

What happens during the procedure

I make a small incision into the abscess to allow the contents to drain, irrigate the cavity to flush it clean, and in most cases place gauze packing inside to keep the wound open. This is intentional — the wound is left open so it heals from the inside out, which prevents the abscess from re-forming. An abscess closed too soon will often come back.

What to expect afterward

Drainage is normal. The wound will continue to drain for several days. It will gradually shift from cloudy or bloody to clear as healing progresses.

Packing changes. If gauze was packed into the wound, it needs to be changed once to twice daily. The technique: remove the old packing (if it sticks, moisten it with saline or warm water), gently rinse the cavity, and place fresh gauze loosely — not tightly — inside. Cover with a clean outer dressing. As the cavity fills in, less packing is needed. I'll guide you on when to stop.

Warm compresses (or sitz baths for perianal abscesses) help with comfort and promote continued drainage — fifteen to twenty minutes, three to four times a day.

Pain should improve significantly once the abscess is drained. Over-the-counter acetaminophen or ibuprofen is usually sufficient after the first day or two.

Activity. Rest for twenty-four to forty-eight hours, then resume light activity. Avoid heavy exercise or anything that puts direct pressure on the wound for one to two weeks. Desk work is usually fine within a few days; physical labor, about one to two weeks.

Signs to watch for

Call the office if you have a fever of 101°F or higher, increasing redness, warmth, or swelling at the site, foul-smelling drainage, red streaks spreading outward from the wound, or if the wound doesn't seem to be getting better after one to two weeks.

Abscesses can recur — if you notice a new lump, tenderness, or drainage near the original site, call promptly. Recurrent abscesses sometimes indicate an underlying fistula (a tunnel between the skin and another structure) that needs further evaluation.

Follow-up is scheduled within one to two weeks. I'll check the wound, assess healing, and determine whether packing is still needed.

When should you come see me?

If you have a painful, swollen lump under the skin — especially one that's warm, red, and getting bigger — don't wait to see if it resolves on its own. Abscesses rarely clear without drainage. The sooner it's treated, the simpler the procedure.

Call the office at (208) 985-6179, or request an appointment through the patient portal.

This page is a summary. You will receive specific wound care instructions for your procedure before leaving the office.