Skin Abscess

What is an abscess? An abscess is a collection of pus caused by a bacterial infection. Abscesses can occur in any area of the body, they are usually painful and mainly found on the extremities, buttocks, breast, perianal area (the area around the anus), or from a hair follicle.

What does an abscess look and feel like? An abscess will appear as a red, tender, swollen, pus-filled lump or swelling under the surface of the skin. Sometimes an abscess can look like an open break in the skin or may form to a head.

Who is affected by abscesses? Abscesses are more common in people with diabetes. However many people with symptoms of an abscess are fit and well with no medical conditions.

What are the signs and symptoms of an abscess? The most common signs and symptoms of an abscess are:

• a smooth swelling under your skin, or an open wound, or sore
• a pus like discharge that smells and appears white, yellow, or green
• pain, warmth, and redness in the affected area
• feeling generally unwell or symptoms of a fever

What causes abscesses? When bacteria gets under the surface of your skin through a minor wound, graze or cut, this can cause an abscess. Alternatively, a sweat gland or oil (sebaceous) gland can become blocked and develop into an abscess.

How are abscesses treated? The treatment that you receive for an abscess will depend on the type of abscess that you have and how large it is. Antibiotics are usually the first line of treatment to help clear the infection if the abscess is small. If antibiotics do not work or the abscess is too large, it will be necessary to drain the pus from the abscess in order to clear the infection. This will require an operation. If an abscess is left it may increase in size and fill with pus until it bursts. This can be very painful.

What does the operation involve? You may have a local anaesthetic (which means the operation will be done whilst you are awake) to numb the area, or a general anaesthetic (which means the operation will be done whilst you are asleep). The surgeon will make a cut above/over the abscess to allow all of the pus to drain. A sample of pus may be sent to the laboratory to confirm what bacteria caused your infection. The hole (wound) that is left by the abscess will then be washed out using saline (salt solution) or an antiseptic. Your abscess wound will usually be left open so that any further pus that is produced can drain away and new healthy tissue can form. You may have a deep wound that is packed with an antiseptic dressing. This will prevent infection and abnormal wound healing. Most wounds should heal within two-three weeks. It may leave a small scar. You are normally able to go home on the same day as your surgery

What are the risks?

• Pain
• Risks of anaesthetic (heart and breathing problems, risk to life)
• Scarring/numbness
• Slow healing of the abscess
• Bleeding
• Recurrence of the abscess
• Infection

Complications are uncommon.

Preventing Deep Vein Thrombosis (DVT) (blood clots)
Your risk for DVT will be assessed and you may require an injection of medicine to prevent blood clots. In addition you may be asked to wear anti-embolic stockings that should ideally be worn until you are back to your usual level of activity (usually 24 hours). If you need to wear them for longer than 24 hours, you should remove them for 30 minutes each day. If possible, avoid long periods of immobility.

What happens after the operation?
You can eat and drink as normal. It is advisable to stop or cut down on smoking as this can delay healing. A referral may be made to your community nursing team who will change the dressing on your wound regularly. Once the community nurse is happy with how your wound is healing they will decide how frequently they will attend to change your dressing.

Before driving you should make sure that you can perform a full emergency stop, have the strength and capability to control the car and be able to respond quickly to any situation that may occur. It is advisable to speak to your insurance company prior to driving to make sure you are insured.

How can I prevent getting an abscess?

• Make sure that your skin is clean, healthy and free of bacteria by washing and drying thoroughly. Having a balanced diet make sure the body has the right amount of vitamins and minerals to help your immune system to fight off infection.
• You may be more at risk of developing abscesses if you are overweight due to bacteria becoming trapped in the folds of your skin.
• Stop smoking – smoking can affect your immune system’s ability to fight infection.

When should I seek help?

• If you have pus coming from your wound.
• If you develop fever or vomiting symptoms for several days.
• Persistent pain not relieved with your prescribed painkillers.

Who can I contact if I have any concerns after discharge?
If you have any concerns or feel unwell after discharge, please contact the Surgical Assessment Unit (SAU) on 01274 383205 to speak with a member of the medical team who will offer advice. The department is open 24 hours a day.