Giant bottomless abscess. Huge cyst pop that just keeps going. Part 1. Packing and f/u coming next.

Please scroll down to watch the video.👇👇

Ah, got it — you’re describing a giant cyst/abscess drainage scenario, maybe like one of those intense medical procedures people watch online. Here’s how that typically goes in Part 1 of the process:

Giant Abscess/Cyst Drainage – Part 1: The Pop

Prep & Clean Area:
- Sterilize the skin.
- Numb the area with local anesthetic.
Incision & Drainage:
- A scalpel is used to make an incision at the point of maximum fluctuation (the squishiest part).
- Pus, blood, and other contents are expressed manually — sometimes with surprising volume if it’s deep or chronic.
Irrigation:
- Saline or antiseptic is used to flush the cavity and reduce infection risk.
Explore the Depth:
- If it’s “bottomless,” a medical professional might use blunt instruments (like a hemostat) to break up internal pockets or loculations of pus.
Packing the Wound:
- Sterile gauze (often iodoform) is packed into the cavity to keep it open and allow healing from the inside out.
- Packing also helps absorb drainage.
Bandage & Instructions:
- A dressing is placed over it.
- Follow-up (f/u) is scheduled for repacking or removal as healing progresses.

Next Up in Part 2:

Packing removal, cavity shrinkage, and continued healing.
Possibly antibiotics if infection risk is high.
Monitoring for signs of recurring infection.

Certainly! Here’s a detailed overview of the incision and drainage (I&D) procedure for a large, deep abscess—often described as a “giant bottomless abscess”—along with guidance on wound packing and follow-up care. This information is based on established medical practices and guidelines.

🩺 Step-by-Step: Incision & Drainage of a Large Abscess

1. Preparation and Anesthesia
- Skin Preparation: Clean the area thoroughly using an antiseptic solution such as povidone-iodine or chlorhexidine.
- Anesthesia: Administer a local anesthetic around and beneath the abscess to numb the area. Note that the acidic environment of an abscess can reduce the effectiveness of local anesthetics, so adequate dosing and time for effect are essential .5 Minute Consult
2. Incision and Drainage
- Incision: Make a stab incision over the most fluctuant (softest) part of the abscess. For larger abscesses, extend the incision or create a cruciate (cross-shaped) incision to fully open the cavity .
- Drainage: Allow the pus to drain naturally. Gentle pressure may be applied to assist in expelling the contents.TeachMeSurgeryNewport Beach Urgent Care
3. Breaking Up Loculations
- Exploration: Use a hemostat or forceps to gently explore the cavity and break up any internal septations or loculations (pockets of pus) to ensure complete drainage .Merck Manuals
4. Irrigation
- Flushing: Irrigate the abscess cavity with sterile normal saline to remove any remaining debris and reduce the risk of ongoing infection .Merck Manuals
🩹 Wound Packing and Follow-Up Care

5. Packing the Abscess
- Purpose: Packing helps keep the abscess cavity open, allowing it to heal from the inside out and preventing premature closure that could lead to reaccumulation of pus.
- Technique: Insert sterile packing material, such as iodoform gauze, into the cavity. The packing should fill the space completely but not tightly. Use a cotton swab or Q-tip to gently guide the packing into all areas of the cavity AAST.
6. Dressing the Wound
- Covering: Place a sterile dressing over the packed wound to absorb drainage and protect the area.
- Maintenance: Keep the wound clean and dry. Avoid soaking the area in baths, as moisture can increase the risk of infection University Hospitals Coventry.
7. Follow-Up Care
- Packing Changes: Depending on the size of the abscess, packing may need to be changed every 1 to 2 days. Larger abscesses may require several packing changes over time Sunnybrook Hospital.
- Monitoring: Watch for signs of infection, such as increased redness, swelling, warmth, or foul-smelling discharge. If any of these occur, contact your healthcare provider.
💊 Additional Considerations
- Antibiotics: While incision and drainage are often sufficient for uncomplicated skin abscesses, antibiotics may be prescribed if there are signs of systemic infection, if the abscess is large, or if the patient is immunocompromised NCBI.
- Pain Management: Over-the-counter pain relievers, such as paracetamol, can be used to manage discomfort. Avoid aspirin-based medications, as they can increase the risk of bleeding University Hospitals Coventry.
🧼 Home Care Instructions
- Hygiene: Wash your hands thoroughly before and after touching the wound.
- Activity: Limit strenuous activities that may stress the wound area.
- Nutrition: Maintain a healthy diet rich in fruits and vegetables to support healing.
For visual learners, here is a video demonstrating the incision and drainage procedure:

Please note: The video contains medical procedures that may be graphic.

If you have any further questions or need more detailed information, feel free to ask!