An abscess is a collection of pus that forms within body tissues, typically as a result of a bacterial infection. The body’s immune system attempts to contain the infection, leading to an accumulation of white blood cells, fluid, and dead tissue. These painful, swollen areas require careful management to promote healing.
Why Abscesses Are Packed
Packing an abscess cavity is common after incision and drainage by a healthcare provider. This procedure’s primary purpose is to keep the wound open, allowing continuous drainage of pus and debris. This prevents the wound’s outer edges from sealing prematurely, which could trap infection and lead to recurrence.
By maintaining an open channel for drainage, packing facilitates healing from the inside out, known as secondary intention healing. As the wound gradually fills with new, healthy granulation tissue, the packing material is progressively removed or reduced. Granulation tissue, which is red and bumpy, forms a scaffold for new cell growth and defends against further infection.
Gathering Your Supplies
Before packing, gather all necessary supplies and prepare a clean workspace. You will need sterile gloves to prevent introducing new bacteria into the wound. Packing material, often sterile gauze strips, fills the wound cavity; these can be plain or impregnated to aid healing or prevent infection.
A sterile wetting solution, such as 0.9% normal saline, moistens the packing material and cleans the wound. This isotonic solution does not harm delicate healing tissues. You will also need medical tape or an outer dressing to secure the packing and protect the wound, along with sterile cotton swabs or forceps for handling the material. A waste container should be readily available for disposing of used materials.
The Packing Procedure
Wash your hands thoroughly with soap and water for at least 20 seconds before handling any supplies. Prepare your work surface by cleaning and covering it with a clean towel. Gently remove the old dressing and packing material, inspecting it for drainage or odor. Immediately place all used materials into your waste bag, then wash your hands again.
Put on fresh sterile gloves to protect yourself and the wound from contamination. Cleanse the wound thoroughly with sterile saline solution, gently rinsing away any exudate or debris. Use a sterile cotton swab to carefully clean around the wound edges, working outwards to avoid spreading bacteria. Ensure the wound is clean before proceeding with new packing.
To prepare the new packing material, cut a length of sterile gauze or packing strip as instructed by your healthcare provider. Place it into a clean bowl and moisten it with sterile saline solution, gently squeezing out any excess liquid until it is damp but not dripping wet. Overly wet packing can cause surrounding skin breakdown, while dry packing can adhere to the wound, causing trauma upon removal.
Carefully insert the moistened packing material into the wound cavity, using a sterile cotton swab or gloved finger to guide it. Fill the entire wound space, ensuring contact with all surfaces, but without packing too tightly. Over-packing can create excessive pressure, leading to pain and hindering blood flow, while under-packing may not adequately promote drainage or prevent premature closure. Ensure a small portion of the packing material extends outside the wound opening for easier removal during the next dressing change.
Once the wound is adequately packed, cover it with a new, clean outer dressing or bandage. Secure this dressing firmly with medical tape to hold it in place and protect the wound. Finally, remove your gloves, dispose of them and the waste bag, and wash your hands thoroughly once more.
Post-Packing Care and When to Seek Help
Ongoing care promotes proper healing after packing the abscess. Dressing change frequency depends on the wound’s condition; heavily draining or infected wounds often require changes 2-3 times daily, while minimally draining wounds may only need changes every 1-3 days. Change the dressing whenever it becomes wet, soiled, or dislodged.
As the wound heals, observe reduced pain, swelling, and redness. Wound drainage should gradually decrease and become clearer, eventually stopping as the infection resolves. The wound cavity will progressively fill with healthy, red granulation tissue, indicating new tissue formation from the base upwards.
Recognize signs of complication or worsening infection requiring immediate medical attention. Increased pain, spreading redness, warmth, or swelling around the wound are concerning. Other warning signs include fever (above 100.4°F or 38.0°C), red streaks, foul odor, or increased pus. If packing falls out prematurely and you are unsure how to re-pack, or if there is significant bleeding that doesn’t stop with direct pressure, contact your healthcare provider.