Uncertainty whether lesion represents focal cellulitis with induration and swelling or an actual abscess (ultrasonography may be helpful) Consider operating room management for Abscesses close to major neurovascular structures (eg, the axilla, antecubital fossa, posterior knee, groin area, neck) Infections of the hand other than those limited to the distal finger (because of complicated anatomy and small areas) Facial infections (because adequate anesthesia is difficult and the cavernous venous sinus is nearby for facial abscesses above the upper lip and below the brow) Large or deep abscesses (alternatively, experienced practitioners with available technology may consider doing ultrasound or CT-guided percutaneous needle aspiration) Complications of Incising and Draining an Abscess Bacteremia and sepsis Chronic draining sinuses and fistulas, secondary to inadequate drainage of deep or complicated abscesses Equipment for Incising and Draining an Abscess Cleansing solution, such as povidone-iodine or chlorhexidine 21 - and 25-gauge needles 10-mL syringe Local anesthetic, such as 1% lidocaine Irrigation syringe Hemostat or small forceps #11 scalpel Culture swab Packing material, such as ½ - to 1-cm sterile gauze strip Absorptive bulk dressing (such as 4 × 4 gauze squares and tape; circular dry gauze wrap on extremities) Nonsterile gloves Additional Considerations for Incising and Draining an Abscess Preincision antibiotics: For patients at high risk of infectious endocarditis complications, immunocompromised patients, and IV drug users, pretreat 1 hour before the procedure with antibiotics effective against staphylococci and beta-hemolytic streptococci (eg, a cephalosporin or, if infection with methicillin-resistant staphylococci is possible, vancomycin or clindamycin).