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A surgical drain is a tube used to remove pus, blood or other fluids from a wound, [1] body cavity, or organ. They are commonly placed by surgeons or interventional radiologists after procedures or some types of injuries, but they can also be used as an intervention for decompression.
The pus needs to be drained, which helps both of these aims. If the tooth is to be removed, drainage will occur via the socket. Otherwise, if pus is already discharging from the periodontal pocket, this can be encouraged by gentle irrigation and scaling of the pocket whilst massaging the soft tissues.
Ubi pus, ibi evacua is a Latin aphorism or adage, often cited [1] in medicine, meaning "where [there is] pus, there evacuate [it]". It refers to what clinicians should do when there is a collection of pus in the body; that is, to create an opening for it to evacuate.
Pus is an exudate, typically white-yellow, yellow, or yellow-brown, formed at the site of inflammation during infections, regardless of cause. [1] [2] An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection of pus within or beneath the epidermis is known as a pustule, pimple or spot.
The dressing should be changed and the wound irrigated with normal saline at least twice each day. [4] In addition, it is recommended to administer an antibiotic active against staphylococci and streptococci, preferably vancomycin when there is a risk of methicillin-resistant Staphylococcus aureus . [ 4 ]
The pus can be removed by a number of methods including needle aspiration, incision and drainage, and tonsillectomy. [1] Incision and drainage may be associated with a lower chance of recurrence than needle aspiration but the evidence is very uncertain. Needle aspiration may be less painful but again the evidence is very uncertain. [13]
Abscess five days after incision and drainage Abscess following curettage. The abscess should be inspected to identify if foreign objects are a cause, which may require their removal. If foreign objects are not the cause, incising and draining the abscess is standard treatment. [4] [32]
Drainage usually involves a surgical procedure. It has been shown that CT-guided drainage brought inferior results than open drainage. Hence, open surgical procedure is preferred to successfully remove the abscess. However, CT-guided drainage is the option treatment for patients who may not tolerate an open procedure.