John R. Tkach, M.D.
300 North Willson, Suite 203B
Bozeman, MT 59715
(406) 587-5442

Post Operative Care of Drained Abscesses and Cysts

Patient Information Sheet

Post Operative Care of Drained Abscesses and Cysts

An abscess is a localized collection of pus in or under the skin caused by a bacterial infection. It usually hurts. It is usually confined to a limited space. A swelling appears that gets red and tender from infection. Sometimes simply draining out the pus allows it to heal. That is a time-honored treatment. Antibiotic pills usually aid faster healing. The pus is made up of bacteria and white blood cells.

What to Expect:

Usually the pain and swelling rapidly improve in 2-5 days after treatment.

Wound Care Post Operatively and During Healing

If the incision for drainage is small such as a needle incision, it will close in a few days. In the first 12 hours, you may be able to pinch out a little more pus. That's okay. If someone else is helping you because the abscess is hard to see or reach, be sure that you and your assistant wash your hands well before and after wound care. Use disposable gloves to avoid spreading infection.

Dr. Tkach will probably direct you to take a prescription antibiotic pill twice a day for 10 days such as minocycline or trimethoprim/sulfamethoxazole (Bactrim DS). An antibiotic cream is not enough. You need pills.

Although the abscess will probably look much better in 5 days, do not stop the antibiotic pills unless you get an allergic reaction to the pills such as hives or rash. Take them for the full 10 days. The biggest cause of failure with this treatment if getting overconfident and stopping the pills too soon. Let Dr. Tkach know if you find you need the antibiotic pills longer. Sometimes it takes an additional 10 days. Change the band-aid every two to three days for 1 week.

Getting More from the Antibiotic

Mild heat will dilate the small blood vessels in the area of the drained abscess. Use low heat. The dilation of the small blood vessels will reach maximum by increasing the skin temperature by 7 degrees. Using extreme heat will not produce better results. Don't scald your skin. The purpose of the heat is to get more antibiotic and blood flow into the infection, NOT to heat sterilize the abscess. The extra blood flow will get more white blood cells into the abscess to fight off the infection. Apply low heat about 1 hour after taking the antibiotic pill and leave it on about 15 - 30 minutes. The blood level of antibiotic should be highest about 1 hour after swallowing the pill.

For example, if the abscess is on your back, put a small electric heating pad on the lowest heat setting, and put it on the bed. Cover it with a thick towel to protect your skin for excessive heat. Lie down with the towel between the abscess (your skin) and the underlying heating pad.

If the abscess is on your front, lie on your back, put the thick towel on the abscess, and put the small electric heating pad set on lowest heat over the towel and not touching your bare skin. Leave it on 15 - 30 minutes. If you can tolerate the heat safely, you could do this 4 times a day for the first few days.

Do not fall asleep on the electric heating pad. You can get burned from prolonged use of the heating pad.

Epidermoid Cysts

A cyst is a basketball shaped piece of skin that is trapped under the skin. A small cyst that does not bother you does not need to be excised. Dead skin accumulates in the cyst. Sometimes germs will get into a cyst and grow on the accumulated dead skin. Simple drainage will often work. A large cyst may require surgical excision and sutures. Suturing cannot be done during infection. You need to let the infection heal first. Don't jump into excision. Give it time to heal. Sometimes the infection itself will destroy the cyst making further surgery unnecessary.

Large cysts may require excision. Just getting out the pus and accumulated dead skin may not be enough. You have to get all the cyst wall and its fragments out.

If you are having trouble with healing call me. It is best to call in the daytime at he office where I have access to the chart. But I am available to my patients at night and on the weekends. My home phone number is published in the book. If you are having trouble, I want to know.

The information provided in these patient information sheets is offered for general informational and educational purposes only; it is not offered as and does not constitute medical advice. In no way are any of the materials presented meant to be a substitute for professional medical care or attention by a qualified practitioner, nor should they be construed as such.

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