CME information and disclosures
To see contributor disclosures related to this article, hover over this reference: 
Physicians may earn CME/MOC credit by reading information in this article to address a clinical question, and then completing a brief evaluation, in which they will identify their question and report the impact of any information learned on their clinical practice.
AMBOSS designates this Internet point-of-care activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only credit commensurate with the extent of their participation in the activity.
For answers to questions about AMBOSS CME, including how to redeem CME/MOC credit, see "Tips and Links" at the bottom of this article.
Incision and drainage (I&D) is a procedure used to drain pus from skin and soft tissue abscesses; it can be performed in both adults and children. This article describes bedside I&D, which should not be performed for abscesses that warrant surgical consultation such as those located near important structures (e.g., nerves, arteries) or in areas of cosmetic concern (e.g., face, breast). During the procedure, an incision is made into the overlying tissue to facilitate pus drainage. Abscess irrigation and packing may be performed after I&D, however, there is limited evidence to support their use. Complications include damage to surrounding structures and abscess recurrence.
- Abscess features
- Abscess location
- Inability to achieve adequate anesthesia
We list the most important contraindications. The selection is not exhaustive.
Incision and drainage
- PPE (mask, gloves, eye shield)
- Surgical drapes
- Antiseptic solution
- Local anesthetic (e.g., 1% lidocaine)
- Syringe with 25-gauge needle
- Scalpel with a No. 11 or No. 15 blade
- Clamp (e.g., hemostat)
- Gauze pads
- Culture swab (if indicated)
- Absorbent dressing
- Sterile normal saline
- Syringe with needleless 18-gauge angiocatheter OR splash cap
- Ribbon gauze (e.g., ¼ inch, ½ inch)
This procedure can be performed in both adults and children.
- abscess dome of the
Incision and drainage 
- Provide local or regional anesthesia.
- Make a linear incision across the length of the abscess with a scalpel.
- Allow pus to drain.
- Consider obtaining a sample for culture. 
- Perform abscess cavity using a clamp to break up loculations. of the
- Consider .
- Consider .
- Cover the incision with an absorbent dressing.
Irrigation and packing 
Both irrigation and packing are often described as part of the I&D procedure, however, evidence that these techniques improve outcomes is lacking. 
- Insert the end of the ribbon gauze into the cavity using forceps.
- Advance the ribbon gauze until the cavity is loosely packed.
- Leave a short tail of ribbon gauze outside the cavity.
Pitfalls and troubleshooting
- Pain 
- Self-contamination: Use adequate PPE.
- Inadequate drainage
- prescribed, if indicated
- Wound care discussed
- Return precautions discussed
- Primary care physician follow-up 24–48 hours postprocedure arranged