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Incision and drainage (I and D) is a widely used procedure in various care settings including emergency departments and outpatient clinics. It is the primary treatment for skin and soft tissue abscesses, with or without adjunctive antibiotic therapy. This activity reviews the incision and drainage procedure, risks and benefits. The role of an interprofessional team will be discussed. Objectives: Identify the anatomical considerations of incision and drainage. Describe the technique of incision and drainage. Outline the appropriate evaluation of the potential complications of incision and drainage. Describe interprofessional team contributions to the comprehensive management of patients with skin and soft tissue abscesses. Access free multiple choice questions on this topic.

Incision and drainage (I&D) is a widely used procedure in various care settings, including emergency departments and outpatient clinics. It is the primary treatment for skin and soft tissue abscesses, with or without adjunctive antibiotic therapy. This activity will focus specifically on its use in the management of cutaneous abscesses. Based on 2013 data from the CDC, cutaneous abscesses accounted for about 2% of all presentations to the emergency department. The same data reports that 0.9% of all patients who presented to the emergency department underwent incision and drainage. In the pediatric population, the incidence of skin and soft tissue infection (SSTI) has increased, and hospitalization due to SSTI doubled in the last 20 years.[1] As such, being well versed in I&D is essential for clinicians in both the adult and pediatric care settings.

Typically I&D is well tolerated with pain being the most common complication. Inadequately drained abscesses can lead to the extension of the infection into adjacent tissues and worsening of clinical status.

The successful treatment of skin abscesses is not limited to clinician proficiency in performing incision and drainage. Often patients will understandably have questions regarding disease recurrence and prevention, and there is a significant amount of research to address these topics. Although bacterial etiology was not discussed in this article, skin and soft tissue infections are many times caused by Staphylococcus aureus, with the prevalence of MRSA increasing. IDSA (Infectious Diseases Society of America) guidelines on the management of skin and soft tissue infections due to MRSA discuss measures to prevent recurrence. These guidelines are derived from important research performed by not only physicians but other integral members of the healthcare team as well. There have been multiple publications by nursing on the subject of recurrence prevention.[11][12] The results of these studies support IDSA guidelines of proper hand hygiene and post-drainage MRSA decolonization with mupirocin. It is important to recognize that standards of care are the result of interprofessional efforts.