Abscess Drainage using Minimally Invasive Surgical Solutions and Procedures and Abscess Drainage
What is a percutaneous abscess drainage?
Everyone knows what an abscess is, and how painful it can be, and how
ill it can make you feel. In the past, drainage of an abscess inside
your chest or abdomen would have required an open operation. Now it is
possible to drain abscesses by inserting a fine plastic tube, called a
drainage catheter, into it through the skin, with only a tiny incision.
This procedure is called percutaneous (through the skin) abscess
Why do I need a percutaneous abscess drainage?
Other tests that you probably have had done, such as an ultrasound
scan or a CT scan, will have shown that you have an abscess, and that it
is suitable for draining through a small tube, rather that by an open
operation. Abscesses can make you very ill, and if they occur after
surgery, will delay your recovery. Although antibiotics can help, they
cannot really be effective against a large abscess. However, once pus
has been drained, this can be sent to the laboratory for tests to show
which is the best antibiotic to treat the remaining infection.
Who has made the decision?
The consultant in charge of your case, and the radiologist doing the
drainage will have discussed the situation, and feel that this is the
best treatment option for you. However, you will also have the
opportunity for your opinion to be taken into account, and if, after
discussion with your doctors, you do not want the procedure carried out,
then you can decide against it.
Who will be doing the percutaneous abscess drainage?
A specially trained doctor called a radiologist. Radiologists have
special expertise in using x-ray and scanning equipment, and also in
interpreting the images produced. They need to look at these images
while carrying out the procedure.
Where will the procedure take place?
Generally in the x-ray department, perhaps in a special "screening"
room, which is adapted for specialised procedures. If it is necessary to
use the CT scanner to guide the drainage, then it will obviously be
done in the CT scanning room. It may be done in an operating theatre,
using mobile x-ray equipment or a portable ultrasound scanner.
How do I prepare for percutaneous abscess drainage?
You need to be an in-patient in the hospital. You will probably be
asked not to eat for four hours beforehand, though you may be told you
can drink some water. You may receive a sedative to relieve anxiety, as
well as an antibiotic. You will be asked to put on a hospital gown.
If you have any allergies, you must let your doctor know. If you have
previously reacted to intravenous contrast medium, the dye used for
kidney x-rays and CT scanning, then you must also tell your doctor about
What actually happens during a percutaneous abscess drainage?
You will lie on the x-ray or scanning table, in the position that the
radiologist has decided is most suitable. You need to have a needle put
into a vein in your arm, so that the radiologist can give you a
sedative to relax you, or painkillers. You may also have a monitoring
device attached to your chest and finger, and may receive oxygen through
small tubes in your nose.
The radiologist will keep everything as sterile as possible, and may
wear a theatre gown and operating gloves. Your skin will be cleaned with
antiseptic, and then most of the rest of your body covered with a
theatre towel. The radiologist will use the ultrasound machine or the CT
scanner to decide on the most suitable point for inserting the fine,
plastic drainage catheter. Then your skin will be anesthetised with
local anesthetic, and a fine needle inserted into the abscess.
What happens next will vary in different situations. The pus may
simply be drained through that needle, or a slightly larger needle or
plastic tube, which is then withdrawn altogether. Alternatively, it may
be necessary to place a larger drainage tube into the abscess and attach
it to the skin so that pus can continue to drain for some days.
Will it hurt?
Unfortunately, it may hurt a little, for a very short period of time,
but any pain you have should be controlled with painkillers.
When the local anesthetic is injected, it will sting to start with,
but this soon wears off, and the skin and deeper tissues should then
feel numb. Later, you may be aware of the needle, or the wire and
catheter, passing into the abscess, and sometimes this is painful. There
will be a nurse, or another member of clinical staff, standing next to
you and looking after you. If the procedure does become painful for you,
then they will be able to arrange for you to have more painkillers
through the needle in your arm. Generally, placing the catheter in the
abscess only takes a short time, and once in place it should not hurt at
How long will it take?
Every patient's situation is different, and it is not always easy to
predict how complex or how straightforward the procedure will be. It may
be over in 20 minutes, or very occasionally it may take longer than 90
minutes. As a guide, expect to be in the x-ray department for about an
What happens afterwards?
You will be taken back to your ward on a trolley. Nurses on the ward
will carry out routine observations, such as taking your pulse, blood
pressure and temperature, to make sure that there are no problems. You
will generally stay in bed for a few hours, until you have recovered.
If the drainage catheter has been left in your body for the time
being, then it will be attached to a collection bag. It is important
that you try and take care of this. You should try not to make any
sudden movements, for example getting up out of a chair, without
remembering the bag, and making sure that it can move freely with you.
It may need to be emptied occasionally, so that it does not become too
heavy, but the nurses will want to measure the amount in it each time.
How long will the catheter stay in, and what happens next?
These are questions which only the doctors looking after you can
answer. It may only need to stay in a short time. It is possible that
you will need further scans or x-rays to check that the abscess has been
drained satisfactorily. You will be able to lead a normal life with the
catheter in place. When the catheter is taken out, this does not hurt
Are there any risks or complications?
Percutaneous abscess drainage is a very safe procedure, and there are
very few risks or complications that can arise. Perhaps the biggest
problem is being unable to place the drainage tube satisfactorily in the
abscess. If this happens, your consultants will arrange another method
of draining the abscess, which may involve surgery.
Rarely, you may get a shivering attack (a rigor) during the
procedure, but this is generally treated satisfactorily with
Despite these possible complications, the procedure is normally very
safe, and will almost certainly result in a great improvement in your
medical condition. Very occasionally an operation is required, but if
the percutaneous drainage had not been attempted, then this operation
would have been necessary anyway.