What is a Fluid Collection and Abscess Drainage Procedure ?
Fluid collection refers to the accumulation of fluid in a specific area of the body due to various reasons. When this fluid collection becomes infected (when it “catches” a microbe), it is termed an abscess. An abscess forms when the body surrounds the infected fluid to prevent the infection from spreading.
In order to heal the infection, the abscess must be drained either through interventional procedures or surgery. Abscess drainage, a minimal invasive procedure, is preferred as the first step before surgery.
Abnormal fluid collections such as abscesses can be drained by inserting a plastic tube (known as a drain or catheter) through the skin (percutaneously) into the collection. Interventional radiologists perform this procedure using imaging techniques like ultrasound or CT scans to guide the process.
How Will I Benefit from the Drainage Procedure ?
Percutaneous drainage is one of the most reliable and least invasive treatments for abnormal fluid collections. It usually prevents the need for more invasive surgical procedures, which may have higher complication risks. The benefits of the procedure include:
What Should I Do Before the Drainage Procedure ?
Before the procedure, you must inform your doctor of all medications you are taking and any allergies you have. If you take blood-thinning medications like aspirin, your doctor may ask you to stop them for a specific period.
Blood tests may be required to check your overall health. You will likely be instructed not to eat or drink for 6-8 hours before the procedure. If you are having the procedure on an outpatient basis, make sure you have someone to accompany you home afterward.
How Is the Drainage Procedure Performed ?
The procedure is performed by an interventional radiologist who will use imaging techniques such as ultrasound, CT, fluoroscopy, or a combination of these methods to find the shortest and safest path to the collection.
After the entry point is identified, your skin is cleaned and sterilized. Local anesthetics will be injected under your skin. If necessary, a small incision (3-4 mm) will be made to allow the tube to pass. A hollow needle is then inserted through the skin to the collection site, and a guidewire is passed through the needle to the collection. Once the needle is withdrawn, a tube is placed over the wire. The guidewire is then removed.
The tube is connected to a small drainage bag outside the body, allowing the fluid to drain from the tube to the bag. The tube is secured in place with adhesive bands or stitches to prevent it from moving or being pulled out. The entry site is covered with dressings.
What Are the Risks ?
Percutaneous fluid and abscess drainage is a safe procedure with a very low risk of complications when guided by imaging techniques. However, damage to surrounding tissues is rare, and if blood vessels are injured, it may lead to bleeding. In rare cases, bacteria may enter the bloodstream, leading to septic shock. This can be treated with intravenous antibiotics and other medications.
What to Expect After the Procedure ?
If the collection was painful, you will likely experience immediate relief. If the collection caused fever, the drainage would rapidly help you feel better. If sedation was used during the procedure, you should expect to regain your physical and mental abilities quickly.
How Do I Care for the Drain and Dressing ? What is the Follow-Up Plan ?
When discharged, you will be given instructions on how to empty and change the drainage bag, clean the catheter, and when to seek emergency medical help. You may also need to take antibiotics after the procedure. The drainage catheter can be removed immediately or may stay in place for weeks or even months, depending on your treatment progress. After most of the fluid has been drained, the catheter can be removed with a simple, painless procedure.