What is Incision and Drainage for Complex, Postoperative Wounds Infection: Overview, Benefits, and Expected Results

Definition & Overview

Post-surgical wounds that have been infected can be treated with incision and drainage.

Infection is one of the common risks faced by all patients who undergo a surgical procedure that requires an incision, or a break in the protective barrier of the skin, which makes contamination from exogenous or endogenous bacteria possible. This is why the majority of surgery patients are given antibacterial medications and post-operative wound care instructions.

When left untreated, post-operative wound infections can become complex and may lead to other, more serious complications, such as sepsis or even death if it spreads through the blood. Fortunately, this can be prevented through a proper incision and drainage procedure.

Who Should Undergo and Expected Results

Patients with post-operative wound infections or surgical site infection (SSI) are commonly subjected to incision and drainage.

SSI makes up around 20% of all infections that arise from health care services, and is the most common post-operative complication that arises from incisions along with wound dehiscence and post-operative blistering. A 2008 study showed that at least 5% of all surgery patients develop an SSI.

Some post-operative wound infections are simple or limited, but some of them are complex. Complex infections can have a major impact on the quality of a patient’s life, and can even lead to a high risk of morbidity and mortality. They can also cause extended hospital confinement and higher healthcare costs.

Serious infections can cause the following symptoms:

• Excessive inflammation
• Specific pain in wound
• Wound separation
• Excessive exudate
• Strikethrough or leakage
• Periwound skin stripping
• Blisters
• Collection of pus or yellow, green, or cloudy drainage seeping from the surgical wound
• Redness that is spiderweb-like or thread-like in appearance
• Raised skins

An incision and drainage procedure is used primarily to release causative organism that has led to the infection as well as the contaminated tissue, including the pus. Once the pus has been released and the wound has been thoroughly cleansed, the skin’s healing process can begin.

How is the Procedure Performed?

The incision and drainage of complex, post-operative wound infections is performed as a minor surgical procedure. It begins with the application of a local antiseptic, such as an iodine-based solution. The surgeon then makes a small incision using a sharp sterile needle or scalpel to puncture the skin to drain out the pus or infected fluid.

For large complex infections, such as abscesses, especially those in the abdominal region, the surgeon may also insert a drainage tube to prevent sepsis. Once the fluid has been drained out, the area is covered with a thin layer of gauze and sterile dressing.

After the procedure, the patient will be instructed to clean the wound with a saline solution and to change the sterile dressing at least twice a day. In most cases, the surgeon will also give the patient an antibiotic to prevent recurrent infections as the wound heals.

For big wounds, the edges of the incision may need to be re-closed with staples or sutures. The entire procedure may take 30 to 45 minutes.

Possible Risks and Complications

An incision and drainage of complex, post-operative wound infections places the patient at risk of:

• Pain
• Bleeding
• Scarring
• Allergic reactions to anaesthesia

Patients who are smokers or have diabetes may also experience delayed healing of the wound.

References:

• Milne J, Vowden P, Fumarola S, Leaper D. “Post-operative incision management.” Wounds UK. http://www.wounds-uk.com/made-easy/postoperative-incision-management

• Jones GA, Butler J, Lieberman I, Schlenk R. “Negative-pressure wound therapy in the treatment of complex post-operative spinal wound infections: complications and lessons learned using vacuum-assisted closure.” J Neurosurg Spine. 2007 May;6(5):407-11. http://www.ncbi.nlm.nih.gov/pubmed/17542505

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**Question:​ What is Incision⁤ and Drainage for Complex, Postoperative⁣ Infection: Overview,⁤ Benefits, and Expected Results?**



**Answer:**



**Overview:**



Incision ⁣and drainage (I&D)⁣ is a surgical‍ procedure performed to treat complex, postoperative infections. It involves making ​an incision in the skin and draining the infected fluid or膿from the underlying⁣ tissues. This procedure⁢ can be necessary when antibiotics alone are insufficient‌ to ⁢resolve the infection. I&D is ⁣typically⁤ performed in a ​sterile operating ⁤room or​ minor surgery clinic.



**Benefits:**



1. **Infection Resolution:** I&D helps to⁣ drain the infected fluid and膿from the‍ surgical⁢ site, thus promoting healing and preventing ​the spread of infection to other parts of the body.



2. **Pain Relief:**⁤ I&D can provide immediate pain relief by releasing ‌the pressure caused by the ‌accumulated膿and fluid.



3. **Improved Wound Healing:** Draining the infected material allows the​ wound to ⁢heal more quickly and effectively.



4.‍ **Prevention of Complications:** ⁣I&D can⁣ help prevent the development of more serious ⁤complications, such as⁣ sepsis and tissue necrosis.



**Expected Results:**



1. **Reduced Infection:**​ The infection is successfully drained and controlled, reducing the risk of ​systemic infection.



2. **Pain Relief:** Patients ⁣typically experience⁤ significant pain relief within a few hours after the procedure.



3. **Improved Wound Healing:** The wound begins to heal and close more⁤ quickly than if ​left untreated.



4. **Prevention of Complications:** I&D helps prevent the development of serious complications, such as sepsis​ and tissue necrosis.



5.‍ **Full Recovery:** In‍ many cases, patients ‌make a full recovery and are able to resume their normal activities ‍within a few⁣ weeks.



**Additional Information:**



1. ⁢**When is I&D Recommended?:** I&D is⁢ typically recommended when antibiotics are ineffective or when​ the infection ⁤is severe and involves a large area.



2. **Who Performs I&D?:** I&D⁢ is​ usually performed by⁢ a ​surgeon or other⁣ healthcare provider with experience in wound management.



3. **Duration of Procedure:** The duration of I&D typically ranges ‍from 30 ​minutes to an hour.



4. **Postoperative Care:** After I&D, patients are usually prescribed antibiotics and may​ require regular wound ​care.



**Conclusion:**



Incision and drainage (I&D) ‍is‌ a valuable surgical procedure for treating ‌complex, postoperative infections. It can provide rapid infection resolution, pain relief, improved wound healing, and prevention of complications. With appropriate postoperative care, patients can typically make a full recovery and resume their normal‍ activities.



**Relevant Keywords:**



* Incision and Drainage

* Complex, Postoperative⁤ Infection

* Infection Resolution

* ‌Pain Relief

* Improved Wound Healing

* Prevention of Complications

* Surgical Procedure

* Antibiotics

* Surgical Site

* Sepsis

* Tissue⁤ Necrosis

* Full ‍Recovery

* Wound Management

* Surgical Care

* Postoperative Care