Sunday, March 03, 2024
Forefoot Surgery SURGERY

Incision and Drainage of Foot: What a Foot Abscess Drainage Entails

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An incision and drainage of the foot is done to treat abscesses in the foot.

An abscess cavity is a pus pocket that has built up in the body tissues. It occurs as a result of an infection. 

An abscess can occur from ulcerations (open sores) in the feet and even puncture wounds. 

Diabetics and even non-diabetics can get abscesses in their feet.

The best way to treat a foot abscess is with an incision and drainage procedure. If the abscess is not evacuated with an incision and drainage surgery, it can spread to other parts of the body and become life-threatening. 

In this article, we’ll discuss what to expect when undergoing an incision and drainage of the foot, as well as the recovery process.

Causes and Symptoms of Foot Abscesses

Foot abscesses can be caused by a variety of factors, such as puncture wounds, ingrown toenails, or ulcers. Diabetics are at risk for foot abscesses due to reduced circulation and nerve damage.

Common symptoms of foot abscesses include pain, swelling, redness, and discharge. If left untreated, the infection can spread and lead to more serious complications.

Preparing for Foot Abscess Incision and Drainage Surgery

Before undergoing incision and drainage surgery for foot abscesses, it is important to prepare for the procedure by discussing any medications you are taking and any medical conditions you have with your doctor.

You may be asked to stop taking certain medications, such as blood thinners, before the surgery. 

You will also need to arrange for transportation to and from the surgery center or hospital, as you will be under anesthesia during the procedure.

wrapping infected foot

Incision and Drainage of Foot Surgery

The incision and drainage procedure will be performed by your Podiatrist under anesthesia in the outpatient surgery center or the hospital. You will be sleeping during the entire surgery. 

If you have a simple abscess (i.e. cutaneous abscesses), you can go home the same day after the procedure. If your foot infection is severe, you may need to remain in the hospital for a few days after the surgery to ensure the infection has cleared.

The first thing your surgeon will do is make an incision over the abscess. The incision will be large enough to allow all of the pus to drain out. 

Once the pus has been drained completely, the wound will be flushed with a sterile saline solution infused with antibiotics. 

If your doctor suspects there’s a bone infection present, your doctor will obtain a bone biopsy at the time of surgery. This involves using a trochar to remove a piece of bone from the infection site. 

To read more about diabetic bone infections in detail, check out this supplemental post: Diabetic Foot Osteomyelitis (Bone Infection)- A Helpful Guide. 

A wound culture will also be obtained to identify the organism responsible for the infection. This will help your doctor decide which antibiotics would work best to clear your infection. 

The wound will be packed and left open in many cases, to allow for the bacterial infection to clear. 

Packing of the wound is a technique used to promote healing in deep wounds. By filling the wound with a sterile material, such as gauze or foam, the packing helps to absorb excess fluid, prevent the buildup of bacteria, and promote the growth of healthy tissue. A dressing will then be applied to the foot. 

The surgery will take 1-2 hours to complete. 

Recovery After Foot Surgery

After the procedure, you will be given instructions on how to care for your wound at home. It is important to keep your wound clean and dry. Use a cast protector from Amazon to help you keep your dressing dry. 

You will also need to keep an eye on your wound for signs of infection, such as redness, swelling, or discharge. 

If the incision was made on the bottom of your foot, you will need to stay off of your foot for 4-6 weeks minimum in a cast boot until sutures come out and your incision site heals. 

If the incision was made on the top of the foot, your doctor may allow you to bear weight as tolerated in a below-knee cast boot for 2-4 weeks. 

Sutures will be removed 2-3 weeks after surgery. If the wound was left open, diligent wound care will be needed at your doctor’s office to ensure the wound heals. 

Depending on the extent of the infection, recovery from an incision and drainage procedure can take 4-6 weeks. 

Complications From a Skin and Soft Tissue Abscess

Return of Abscess

One possible complication is that the abscess may return. If the abscess does return, it may need to be drained again. This can happen if the previous infection had not completely cleared up. 

It is important to follow the instructions given by your doctor to help prevent this from happening. 

Excessive Bleeding

Excessive bleeding is another complication that can occur after an incision and drainage procedure. If you are on blood thinners and the wound has been left open, excess bleeding may occur. 

Talk to your doctor if your postoperative bandage becomes soaked and the bleeding does not stop. 

Nerve Injury

A third complication that can occur after an incision and drainage procedure is nerve injury. Unfortunately, nerve damage can occur after an incision and drainage procedure. 

Nerve damage may be temporary or permanent. You may feel numbness, tingling, or burning after the procedure. 

Some people have peripheral vascular disease, which causes decreased blood flow to the foot. In these people, surgical incision sites may not heal. 

It is important to get vascular surgery involved in this case. If the blood flow in the foot is poor, the vascular surgeon can help improve the flow in the foot by inserting a stent in the leg or performing a bypass procedure to improve blood flow. 

When Should You Follow Up With Your Doctor After an Incision and Drainage Procedure?

Make sure you follow up with your physician within 1 week after the incision and drainage procedure. 

Your doctor will need to assess the surgical site to ensure it is healing properly. Your doctor will provide you with appropriate recommendations about wound care. 

antibiotics

Are Antibiotics Necessary After the Procedure?

If the infection is moderate to severe, your doctor will suggest you continue antibiotics after an incision and drainage procedure. This is especially true if there is a bone infection. 

Can Patients Drive After Surgery?

After incision and drainage foot surgery, patients are usually advised not to drive for at least 4 weeks, depending on the type and extent of the surgery performed.

Drainage of an abscess may cause temporary numbness or weakness in the foot, making it difficult to control the pedals and operate the vehicle safely. Also, the patient may experience pain, swelling, or discomfort in the affected foot, which can also interfere with driving. 

It is important for patients to follow their doctor’s post-operative instructions carefully and avoid driving until they feel comfortable doing so. 

Signs That You May Have an Abscess in the Foot

Initial signs of a foot abscess include pain, swelling, redness, warmth, and tenderness in the affected area. The skin in the area may appear stretched or shiny, and there may be drainage or discharge from the site. 

In some cases, individuals may experience systemic symptoms, such as fever, chills, or fatigue, which can indicate that the infection has spread beyond the abscess and into the bloodstream. 

If you suspect you have an abscess in your foot, it is important to seek prompt medical attention to prevent complications. 

Prevention of Foot Abscesses

Preventing foot abscesses involves proper foot care, especially for those with diabetes. This includes keeping the feet clean and dry, wearing proper footwear, and checking the feet regularly for any signs of injury or infection.

It is also important to manage blood sugar levels and maintain a healthy diet and exercise routine to promote overall health.

Conclusion

Foot abscesses are fairly common soft tissue infections that can cause significant pain and discomfort. If you think you may have a foot abscess, it is important to see a doctor so that they can determine whether or not you need incision and drainage surgery.

Foot infections are serious and should be treated immediately with emergency debridement. 

Make sure you contact your local Podiatrist so that he/she can provide appropriate management and treatment for the infection.

DISCLAIMER:
The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Vaishnavi Bawa
Dr. Vaishnavi Bawa is a Podiatrist who specializes in treating foot and ankle pathology. LifesLittleSteps mission is to educate the public about foot health in an easy-to-understand manner using evidence-based medicine.
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