Surgery of an abscess

introduction

Abscesses can occur in different parts of the body, such as the chest, skin or teeth, and cause discomfort. Abscesses are particularly feared because of possible complications, especially blood poisoning. Abscesses are collections of pus that have their own capsule. The pus accumulates in a body cavity, which is created by melting down tissue and was not there before.

To the main article: Abscess - cause, symptoms, therapy and prognosis. You might also be interested in: Abscess - The Different Forms.

To get rid of an abscess, one has to open it up and remove the pus. The abscess and its capsule should be removed so that it does not appear in the same place again. The treatment of choice for an abscess is surgical opening. There are various procedures for this, which differ depending on the location and extent of the abscess. The following article deals with different operations on an abscess and answers interesting questions about the topic of "OP of an abscess".

Alternatively, read: Home remedies for an abscess.

Procedure for an abscess

Which surgical procedure is considered for an abscess depends to a large extent on the type and location of the abscess. A common procedure is abscess splitting. An abscess splitting is mainly carried out on superficial skin abscesses. The procedure can be carried out under regional or general anesthesia (under general anesthesia).
The area around the abscess is first cleaned and disinfected. The procedure is carried out under sterile conditions. The abscess is opened with an incision. If the abscess is a little deeper, the tissue over the abscess is spread open with a clamp. In this case, one speaks of a blunt preparation, as the tissue is not cut open further with a scalpel.
Once the abscess is opened, the surgeon will drain the pus. The abscess cavity is then rinsed so that all remnants of the pus are flushed out. Dead tissue may also be removed. The wound is deliberately left open and not sewn shut so that the tissue heals from the inside out and an abscess cannot form again under the suture. A kind of tab or a plastic tube, also called drainage, may be inserted so that the wound does not immediately overgrow and any remaining pus and wound secretions can drain away.

The abscess splitting is usually carried out within a few minutes and can often also be carried out on an outpatient basis. This is not the case if abscesses are deep in the body, for example in the abdomen. In this case, simply splitting the abscess is not possible. Major surgery to remove the entire abscess and its capsule may be required. This is the case with an intestinal abscess. These are larger interventions that take place under general anesthesia and are usually accompanied by an opening of the abdomen. In-patient follow-up treatment is necessary in this case.
Anal abscesses usually also require adapted surgical procedures. Basically here too the abscess is opened and the pus removed; however, the location of the abscess may require a special incision. Anal abscesses can be very close to the sphincter, which is why the location of the abscess has to be checked again and again using an ultrasound device. This ensures that the sphincter muscle is not injured by an incorrect incision.

Abscess drainage

An abscess drainage is a small tab or plastic tube that is inserted into the abscess cavity. The pus contained in it can drain through it. Abscess drainage can be inserted for various reasons. Often superficial abscesses are split open first. The pus is removed as far as possible and the abscess cavity is rinsed. A thin plastic tube is often inserted into the wound, through which any remaining pus and wound secretions can drain away. Abscess drainage can also be used for deeper abscesses if they are difficult to reach openly surgically. In this case, the drainage is introduced by means of a puncture. The puncture is performed under visual control with an ultrasound or CT machine. While the doctor punctures the abscess and inserts the drainage, he can use the device to check the correct location of the drainage tube.

Tamponade

After an abscess has been operated on, packs are often inserted into opened abscess cavities. Tamponades are usually compresses or bandages that are inserted into the abscess cavity and fill it. They are often soaked with disinfectant and antibiotic additives. This is often the case with abscesses in the oral cavity, for example, but also with other superficial abscesses. Tamponades are usually changed daily or every two days. In the case of superficial skin abscesses that are treated on an outpatient basis, the patient can change the tamponade himself. Inpatient abscesses are treated by the responsible ward physicians.

The aftercare

Follow-up treatment for an abscess differs depending on the location and type of the abscess. Superficial abscesses require special wound care, whereas internal abscesses require further treatment in the hospital. The far more common superficial abscesses can be treated on an outpatient basis. The attending physician explains to the patient exactly what to look for in wound care. As a rule, the wound cavity that has been operated on is rinsed several times a day with a saline solution. If compresses are on the wound, these are also changed several times. They are usually also soaked in saline or a disinfectant additive. Hygiene is particularly important, otherwise infections can develop in the open wound.
If there is a drainage in the wound, it will be pulled out as soon as no or only very little wound secretion drains out of it. The wound heals on its own from the inside out and is not sutured. In the case of deeper abscesses, for example intestinal abscesses, follow-up treatment is carried out on an in-patient basis, as it involves extensive surgical interventions. In this case, the patient does not have to do much, except to take care of physical rest.No tobacco or alcohol should be consumed after each operation, as this can lead to wound healing disorders. Physical exertion and sport are also to be avoided in the beginning until the wounds have healed.

Abscesses can also recur, so it is recommended to prevent abscesses in everyday life. You can find out how to prevent abscesses here: What is the best way to prevent an abscess?

Does the procedure take place on an outpatient or inpatient basis?

Whether the operation for an abscess is performed on an outpatient or inpatient basis depends on the location and type of the abscess. Superficial abscesses can usually be opened in an outpatient operation. Above all, this includes skin abscesses.
However, abscesses that are deep in the body, such as the abdominal cavity, require inpatient surgery (see also: Abscess on the abdomen). Extensive abscesses, for example in the anal area, are often operated on in an inpatient setting. The decision as to whether an abscess can be treated as an inpatient or an outpatient must be made individually. Abscesses that protrude deep into muscle layers or even the bones (read also: Bone abscess) infiltrate, are operated on inpatient and not outpatient.

Scar after splitting abscess

Many sufferers worry about the scarring that this procedure can cause after an abscess operation. Scars can occur, but their size and shape vary greatly from person to person. It depends a lot on the person's tissue and the type of surgery. Very large cuts, skin areas in which the skin is under great tension and wound healing disorders can lead to pronounced scarring. However, the cosmetic results after an abscess operation are often very satisfactory and the scars are vanishingly small. For good wound healing, it is very important to adhere to the hygiene recommendations and to refrain from smoking and alcohol consumption. Furthermore, heavy physical stress should be avoided until the wound has healed, as this can also interfere with wound healing.

Risks of having an abscess surgery

As with any other operation, there are certain risks involved in an abscess operation. There are both general and specific surgical risks. General risks of abscess surgery include bleeding, injury to surrounding tissue, injury to nerves, muscles, or adjacent organs, and infection. However, these complications rarely occur, but the patient must be informed about them.

After an operation, there may be a relapse, i.e. a new abscess on the operated site. A thorough approach and good aftercare try to minimize this risk as much as possible. A serious complication of abscess surgery is the development of blood poisoning. However, this complication is very rare. As after any procedure, wound healing disorders and scarring can occur.

Length of sick leave

The duration of a sick leave after an abscess operation differs depending on the course of the operation and the patient's condition. Superficial abscesses that have been operated on on an outpatient basis usually do not require a long sick leave. Work can often be resumed the next day, unless it is heavy physical work or work that otherwise interferes with wound healing. The course of the operation also plays an important role. If the operation has resulted in complications, a sick leave will of course be given until the person concerned has improved. Larger abscesses and extensive surgeries can even require weeks of sick leave. This is the case with bowel abscesses, for example. These are treated as inpatients and usually need at least two to three weeks before the patient can be discharged. The duration of a sick leave can therefore not be specified in general and is very much dependent on the individual course, the state of health and the type of work.