Treatment Healing usually requires surgical drainage of the contents. Rupture of the abscess may result in spontaneous drainage, sometimes associated with the formation of chronic draining sinuses. Without spontaneous or surgical drainage, an abscess occasionally resolves slowly after proteolytic digestion of the pus produces a thin, sterile fluid that is resorbed into the bloodstream. Incomplete resorption leaves a cystic loculation within a fibrous wall, where calcium salts sometimes precipitate to form a calcified mass. Systemic antimicrobial drugs active against the responsible organisms are indicated for deep-seated infections but are often ineffective without concurrent drainage.
Adequate drainage consists of thoroughly removing pus, necrotic tissue, and debris.
To prevent reformation of the abscess, elimination of dead space by packing with gauze or by placing drains may be necessary. Predisposing conditions, eg, obstruction or the presence of a foreign body, require correction if possible. Gram stains and cultures followed by susceptibility studies of isolates obtained from the abscess provide a guide to antimicrobial therapy. All rights reserved.