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Total Knee Replacement Surgery (TKR) icon

Procedure Name

Percutaneous Abscess Drainage
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Surgery Type

Closed
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Hospital Stay

1-2 Days
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Duration of Surgery

20 minutes to 60 minutes
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Type of Anesthesia

Local Anesthesia/ General Anesthesia
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Full Recovery

2 to 3 weeks

Overview

Percutaneous abscess drainage is a minimally invasive procedure to drain any abscess in your body, through the skin. An abscess is an abnormal buildup or collection of inflammatory fluid known as pus, consisting of dead white blood cells, bacteria, and tissue debris. It is formed as an inflammatory response to an infection in your body. Percutaneous drainage is an image-guided (the ultrasound or CT images guide the surgeon to locate the abscess) drainage procedure of an abscess which is usually recommended when other non-surgical treatments, such as antibiotics, fail to provide relief. It is a stitch less and bloodless procedure, an excellent alternative to open surgical drainage.

What is Meant by Percutaneous Abscess Drainage?

Percutaneous (through the skin) abscess drainage is a procedure that is performed to remove pus from an abscess through a tiny incision. This ultrasound or CT (Computed Tomography)guided procedure helps the doctor locate the abscess for needle insertion through the skin (percutaneous) overlying the abscess. The pus is either drained through the inserted needle attached to a drainage bag or a catheter (a thin, hollow, flexible tube-like device) that is inserted into the abscess (for a large and severely infected abscess) for further drainage of residual (left out) pus.

Percutaneous drainage is performed through two techniques:

  • The Seldinger Technique- This technique involves a “blind” insertion of the catheter into the abscess without direct visualization of the abscess cavity.
  • The Trocar Technique- This is a drainage technique where the catheter is advanced to the exact location of the abscess through a cannula (hollow tube) known as a trocar that acts as a portal for catheter insertion. 

When is a Percutaneous Abscess Drainage Recommended?

Percutaneous drainage is often recommended since it is a less traumatic procedure with quick recovery. It is indicated:

  • When other non-surgical methods like antibiotics fail to provide relief.
  • For abscesses that are greater than 3 cm in diameter.
  • To relieve symptoms associated with an abscess, such as pain around the affected organ, high-grade fever (>103), body aches, chills, nausea, and vomiting. This helps to improve your overall quality of life.
  • For diverticular abscess (abscess formed in one of the pouches of the alimentary canal), complicated or ruptured appendix (a small finger-shaped pouch projecting from the colon), liver abscess, intraabdominal abscess (an abscess formed inside your belly), intramuscular fluid collection (inflammatory fluid collected within muscle tissue).
  • For multiple abscesses with multilocation (having many cavities or compartments within the abscess).
  • Noncompliance (not willing to cooperate) with open surgical drainage.

How to Prepare for a Percutaneous Abscess Drainage?

Evaluation of an abscess and preparation for percutaneous drainage involves the following.

Medical history

Your healthcare provider will evaluate the symptoms, such as the pain's intensity, duration, and location. You are advised to discuss any medical condition like diabetes (increased blood sugar levels), or recent illnesses with your doctor, including any chance of being pregnant. A list of all medications (blood thinners, anti-inflammatory drugs, etc.), including herbal supplements currently taken, should be mentioned, in addition to any history of allergies, trauma or surgeries. Discuss your social habits (like smoking, alcoholism, and tobacco use) with your doctor for the necessary precautions to be taken during and after percutaneous abscess drainage.

Physical examination

It is important for your doctor to examine you physically so as to correlate your clinical/physical symptoms with the diagnostic findings. Your doctor will palpate (examine by touch) the affected area for tenderness, pain, swelling, or any skin (overlying the area of abscess) changes. 

Diagnostic tests 

  • Blood routine and culture: Helps identify any bacterial infection that may increase your chance of abscess formation.
  • Urine routine: This test can check for sugar and other proteins in your urine sample to detect diabetes and other pathologies.
  • Chest X-ray: To help rule out any pathologies affecting your lungs, such as pneumonia.
  • Ultrasound scan: To detect the presence of an abscess and its location.
  • CT scan: This provides detailed information about the abscess and its contents and helps to determine its exact location and size.

Preparation before surgery

Based on your diagnostic findings, your surgeon will determine if percutaneous drainage is the right treatment choice for you. Due to the risks involved with percutaneous drainage, your doctor will advise you to:

  • Temporarily discontinue medications like blood thinners and other herbal supplements 2 weeks before the drainage.
  • Quit smoking and alcohol consumption at least 2 to 3 weeks before the surgery.
  • Fast 8 to 12 hours before the abscess drainage if performed under general anesthesia. 

How is Percutaneous Abscess Drainage Performed?

Percutaneous abscess drainage is usually performed by an interventional radiologist (a doctor especially trained to carry out image-guided, minimally invasive procedures to diagnose or treat diseases related to any organ), or a proctologist (a doctor specializing in the diseases of the colon, rectum, and anus) or a general surgeon under image guidance (CT or ultrasound).

  • On the day of the procedure, you will be made to sign a consent form (official permission given to the doctor to conduct the procedure). 
  • Your nurse will prep you by shaving the area for catheter insertion to remove any excess hair. 
  • The area will be disinfected using an antiseptic solution to remove surface contaminants. 
  • Your nurse will attach medical devices that track your vitals (pulse, blood pressure, etc.) throughout the procedure. 
  • An IV line will be introduced for intravenous sedation and fluids. You will be administered either local (numbs only a particular area of the body) or general anesthesia (sedates you completely and puts you to sleep), depending on the type and severity of the abscess. 
  • Your surgeon will begin the procedure by locating the abscess under ultrasound or CT guidance.
  • The drainage is performed by one of the following techniques:

Seldinger Technique (Two-step procedure)

  • Once the abscess is located, your surgeon will use a thin, long aspiration needle that will be inserted directly (blind insertion) into the abscess through the skin overlying it.
  • Then a guide wire will be inserted through this needle and the needle will be withdrawn.
  • Dilators of different dimensions will be introduced through the guide wire to create a hole or passage for catheter insertion.
  • The guidewire will be withdrawn and the catheter tube will be secured in place until the residual pus has been drained and there is no sign of any infection on the ultrasound or CT scan. 
  • This procedure takes around 45 to 60 minutes.

Trocar technique (One-step procedure)

  • After locating the abscess, your surgeon will advance the catheter into the abscess through a trocar (a hollow tube or cannula). 
  • The trocar consists of a needle and circular drainage system (coaxial catheter system), through which the catheter drain will be inserted directly into the abscess.
  • The needle and cannula will be withdrawn, leaving the catheter behind.
  • This technique usually takes 20 to 30 minutes.
  • Your surgeon will secure the catheter through surgical tapes to prevent dislodgement.

What to Expect after a Percutaneous Abscess Drainage?

You will be observed in a recovery room for the initial few hours after the drainage procedure. 

  • You may experience mild pain, discomfort, and dizziness when the effect of anesthesia begins to wear off. 
  • A burning or pricking sensation may be felt near the area of catheter placement. 
  • Your nurse will monitor your vitals, and once stabilized, you will be shifted to your hospital bed for further recovery. 
  • You are expected to stay in the hospital for a day or two, depending on the severity of the abscess and the pus drainage.
  • You will be prescribed painkillers and antibiotics to help relieve pain and prevent post-op infection.
  • You may begin a bland liquid diet 7 to 8 hours after the procedure, and once you can take in liquids, you will progress to a semi-solid diet the following day.
  • The drainage output will be periodically monitored through the fluid collected in the catheter bag. The amount of drain indicates your recovery progress. 
  • Your surgeon will evaluate the drained site through ultrasound images to monitor the healing. 
  • You must schedule at least one follow-up visit to ensure your body is healing at an appropriate pace. Once your body has recovered, the radiologist will remove the catheter.
  • Complete recovery after percutaneous drainage may take around 2 to 3 weeks. 

What are The Benefits and Risks of Percutaneous Abscess Drainage?

Image-guided percutaneous abscess drainage is the most preferred choice of treatment in comparison to open surgical drainage due to the following benefits.

Benefits

  • It is a minimally invasive procedure less traumatic to the surrounding tissues and structures.
  • The drainage does not involve extensive incisions or cuts; only a small nick or puncture for needle insertion is sufficient.
  • There is minimal or no scarring at the needle penetration area.
  • The drainage technique involves reduced risk of bleeding.
  • Minimal procedure time with quick healing and recovery.
  • You can resume your job and other activities within a short time.
  • The procedure involves fewer post-op precautions that need to be followed.

Risks

There can be occasional risks and complications associated with percutaneous abscess drainage, such as:

  • Allergic reactions to anesthesia may cause skin rash, hives, itching, severe redness, edema (swelling) around your eyes and lips, nausea, vomiting, dizziness, and breathing issues.
  • Hematoma (abnormal swelling beneath the skin due to blood clot formation).
  • Damage to the nearby nerves during needle penetration leads to numbness and a tingling sensation around the affected area.
  • Slight risk of skin infections near the needle penetration.
  • The catheter can be dislodged from its place or may be blocked, requiring manipulation or replacement of the catheter.
  • Very rarely, an adjacent organ may be damaged during needle or catheter insertion.

Why Choose Medfin?

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin! 

The power of Medfin in patient’s words

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“ Got to know about them from my friend. They got an appointment for only 299. Once the doctor confirmed that I needed the surgery they got me a fixed cost which included ALL the costs. No extra amounts were charged. Thank you Medfin”

Suresh Menon Hyderabad 8 days ago
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“ After my consultation with the doctor, MEDFIN representative got me a fixed package cost that included my mothers initial tests, surgery cost. They also gave me stockings free for Rs. 3000 post the surgery. They kept up their promise they made”

Radhika Iyer Mumbai 8 days ago
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