7. If indicated, insert plain, 0.5-inch gauze into abscess

cavity to stop bleeding and/or to serve as a wick to promote drainage (Fig. 48.2B).

8. Apply dry, sterile dressing.

9. Remove half of gauze packing in 24 hours and remainder within 48 hours. (Some larger wounds may require

multiple packing changes.)

10. Check abscess wound, and apply sterile warm soaks for

20 to 30 minutes, three times a day, until healing has

commenced, as indicated by

a. Cessation of drainage

b. Formation of granulation tissue

c. Resolution of local tissue inflammation

A B

Fig. 48.2. Drainage of a superficial abscess. A: Breaking the

septa with a clamp. B: Packing the wound.

Fig. 48.1. Superficial abscess in the site of a Broviac central

venous line insertion in the left anterior chest wall.

356 Section IX ■ Miscellaneous Procedures

G. Complications

1. Introduction of infection into sterile abscess or hematoma

2. Local bleeding

3. Injury to blood vessels, nerves, or tendons (deep to

abscess cavity) (5)

4. Incomplete drainage with recurrent abscess formation

(1,3)

5. Systemic infection (21,22)

6. Scar formation at drainage site, requiring skin graft (23)

7. Reduction of breast size following incomplete drainage

of breast abscess (24)

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