INCISION AND DRAINAGE OF ABDOMINAL WALL ABSCESS
Indication: Subcutaneous or deep abdominal wall abscess (post-operative wound infection, de novo abscess, or infected haematoma).
Patient Position: Supine (or as appropriate for abscess location).
Anaesthesia: Local with sedation, or general for deep or complex collections.
Procedure:
1. Abscess site identified clinically and confirmed with ultrasound or CT if necessary.
2. Area cleansed and draped.
3. Incision made over the point of maximum fluctuance — sufficient length to allow adequate drainage.
4. Abscess cavity entered. Pus evacuated and sent for Gram stain and culture.
5. Cavity explored digitally. Loculations broken down.
6. Wound irrigated with normal saline.
7. Wound packed loosely (gauze wick or alginate) or left open to allow drainage and secondary healing.
8. Skin: not sutured primarily in contaminated wounds.
Finding(s): [Abscess: site and size. Pus: __ mL — culture sent. Cavity: loculated / unilocular. Wound: left open / lightly packed.]
Complications Noted: [None / deeper extension — further debridement / specify.]
Postoperative Instructions: Daily dressing changes. Antibiotics only if cellulitis or systemic infection. Wound care and monitoring for healing. Wound to close by secondary intention.