Incision and drainage (I&D) and debridement: an OR 101 guide
Reviewed by Rodnie Oro, cath lab charge nurse · Last reviewed: October 2026 · Education only, not medical advice
I&D and debridement in one minute
What it is: surgery to open and drain an abscess (I&D), or to remove dead or infected tissue from a wound (debridement).
Who it is for: people with an abscess, an infected wound, or a wound with dead tissue that will not heal.
Main risks: bleeding, pain, the abscess coming back, needing further operations.
Usually: under general or local anaesthetic, 15–60 minutes, often home the same day.
On this page: What are I&D and debridement? · Who is it for? · When is it done? · Step by step · Recovery · Risks · Kit list · First time in theatre? · FAQ
What are I&D and debridement?
An abscess is a collection of pus under the skin or deeper. Antibiotics alone often cannot reach it, so it needs to be opened and drained.
- Incision and drainage (I&D): the abscess is cut open, pus is drained and samples sent to the lab, and the cavity is washed and often packed
- Debridement: dead, damaged or infected tissue is cut away from a wound until healthy, bleeding tissue is reached, so the wound can heal
Severe infections such as necrotising fasciitis need urgent, sometimes repeated, debridement.
New to the acronyms? See the Cath Lab Abbreviations A–Z.
Who is it for?
It may be considered for people with:
- a skin or soft-tissue abscess, for example in the armpit, groin or buttock
- an abscess near the back passage (perianal)
- an infected or non-healing wound with dead tissue
- severe spreading soft-tissue infection (emergency)
The decision is made by your surgical team, who will talk through the reasons, the alternatives and the risks with you.
When is it done?
It is often done urgently. Before it, you usually have:
- an examination, and sometimes a scan to see how deep it goes
- blood tests, including diabetes checks
- antibiotics, as per centre protocol
- a chance to ask questions and give consent
Step by step
1. Getting ready
Team brief and WHO checklist first. The anaesthetic team and ODP give the anaesthetic (general, regional or local, as per centre protocol); antibiotics and blood-clot prevention are given as per centre protocol. The circulating practitioner checks positioning, pressure areas, the diathermy plate and warming. The scrub practitioner sets up the instrument trolley and does the first count. Positioning depends on the site.
2. Access
The cut is made over the most fluctuant part of the abscess, or the wound edges are opened, sized per surgeon.
3. Draining and cleaning
- A. Abscess found. The abscess is identified and a cut made over it.
- B. Pus drained. Pus is drained, samples taken, and pockets gently broken down.
- C. Dead tissue removed. Dead or infected tissue is cut away until healthy tissue is reached.
- D. Washed and packed. The cavity is washed and often packed or covered with a dressing.
4. Finishing
Wounds are usually left open to heal from the base, with packing or a dressing; a negative-pressure dressing may be used, per surgeon. Final counts are confirmed before closure, specimens labelled and checked, and the patient goes to recovery with a full handover.
Recovery and aftercare
- First hours: in recovery, then a ward or day unit; pain relief and anti-sickness medicine as needed.
- Going home: often the same day; longer for severe infections.
- Activity: walking early; gentle activity as comfortable; ask your team.
- Dressings: packing and dressings are changed regularly by nurses, sometimes for several weeks.
- Antibiotics: some people continue antibiotics.
- Wounds: keep them clean and dry as advised; sutures or clips may need removing.
- Follow-up: clinic review or a phone call, as per centre protocol.
Call 999 if you have severe pain, heavy bleeding, breathlessness or collapse. Contact your team or GP if you have a fever, worsening tummy pain or swelling, vomiting, or a wound that becomes red, hot or leaky.
Risks and complications
Your team will explain the risks that apply to you. Possible problems include:
- bleeding
- pain at dressing changes
- the abscess coming back
- a slow-healing wound or scarring
- spreading infection needing further surgery
Theatre kit list (printable)
Example kit list
Every theatre has its own protocol, and sizes and doses vary.
- minor or general instrument set
- scalpel, curettes and scissors
- swabs for microbiology and specimen pots
- washout fluid and syringes
- packing and dressings, or negative-pressure dressing kit, per surgeon
- local anaesthetic, as per centre protocol
Procedural steps
- Team brief, WHO sign in; anaesthesia
- Positioning for the site; prep and drape; count
- Incision; pus drained; samples taken
- Loculations broken down; debridement to healthy tissue
- Washout
- Packing or dressing; counts (including packing); sign out and handover
First time in theatre?
đź’ˇ First-time tip
- Know your role. Scrub, circulating, anaesthetic and ODP each have their own checks; ask at the team brief.
- Counts matter. Swabs, needles and instruments are counted before, during and at closure; speak up if one is missing.
- Specimens. Label every specimen with site and side, and check it with the scrub practitioner before it leaves theatre.
- Packing count. Record exactly how much packing is left in the wound so it can all be removed later.
- Infection control. Follow local rules for contaminated cases and instrument handling.
FAQ
Why isn't the wound stitched closed?
Leaving it open lets it drain and heal from the base, reducing the risk of the abscess coming back.
How long will it take to heal?
Days to weeks, depending on size and site.
Do I need antibiotics?
Sometimes. Your team will decide.
Related guides
Sources
All checked on 14 October 2026. Each page's own date is shown where it gives one.
- NHS. Skin abscess. nhs.uk/conditions/skin-abscess
- StatPearls (NCBI Bookshelf), search: incision and drainage. ncbi.nlm.nih.gov/books
- StatPearls (NCBI Bookshelf), search: debridement. ncbi.nlm.nih.gov/books
- World Health Organization. Surgical Safety Checklist. who.int
Disclaimer
Education only. This page is for general education for healthcare students, theatre staff and curious readers. It isn't medical advice and doesn't replace advice from your own doctor, surgical team or local unit protocols. Equipment and medicines are described generically. No product or manufacturer is recommended. If you think someone is having a medical emergency, call 999.
Disclosure: I work in the medical device industry. This page is independent education and isn't sponsored or reviewed by any company.
All diagrams on this page are original illustrations created for rodnieoro.com.
