Incision and Drainage Set: Instruments for Abscess Drainage in Clinic and Theatre

What goes in an incision and drainage tray

A typical I&D instrument set contains a scalpel handle with blades, a curved haemostatic forceps (usually a mosquito or Kelly type) to open the cavity, dissecting forceps, a probe or grooved director, small scissors, a small retractor or two, a kidney dish, a bowl for irrigation, and gauze. Packing forceps or a suture set may be added.

The set is intentionally small, because a minor procedure tray is usually opened at a bedside or in a treatment room where space is limited. Standard patterns reduce errors and make it easy for any nurse to set it up quickly. See the minor surgery instrument set for the wider concept.

Think also about what is not in the tray. Irrigation syringes, drain material, local anaesthetic, dressings and personal protective equipment are normally supplied separately, and a checklist that lists both the tray and these consumables prevents delays once the procedure has started.

Abscess drainage instruments: the key pieces

The scalpel makes the incision, and the haemostatic forceps are inserted closed and opened to disrupt septa and widen the drainage tract. REDA's forceps and clamps range lists Halsted-Mosquito, Crile and Kelly, among others, in straight and curved versions and several lengths, so the right size can be chosen for the depth of the cavity. See mosquito forceps for details.

A buttoned probe or grooved director is used to explore the cavity and to find a sinus. REDA's general surgery section lists buttoned probes and grooved directors, kidney dishes, round bowls and instrument trays, which fit the I&D tray.

Length matters. A 12.5 cm mosquito reaches a shallow subcutaneous collection comfortably, while a deeper cavity may call for a 14 to 15 cm clamp. Offer both sizes in the central stock so that the clinician can choose without opening a second tray.

• Scalpel handle and blades: pick the blade size your clinicians use for small incisions.
• Haemostat: curved, 12 to 15 cm range, to open the cavity.
• Probe or director: to explore and to place a drain.
• Scissors and dissecting forceps: to cut packing and handle tissue.

Incision and drainage tray: reusable or single-use

Single-use packs are convenient in emergency departments because they are sterile, ready and require no reprocessing. They are suitable for low volumes and for settings without a central sterile department. Reusable trays are more economical at high volume and allow instruments of higher quality, but they require validated cleaning and sterilization.

Make the decision on volume, storage, waste policy and training. For a wider discussion, read disposable vs reusable surgical instruments. REDA's sterilization container system can hold reusable sets, with full, three-quarter and half sizes; see the sterilization containers range for your department.

Whatever you choose, label the tray clearly, include an indicator for sterility, and record the batch or processing cycle for traceability. This is the basis of a safe minor procedure service.

Safety, cleaning and aftercare

I&D involves infectious material, so sharps safety and personal protection are essential. Use a sharps container, dispose of blades immediately and avoid recapping. Instruments should be cleaned promptly, with organic matter removed before it dries, and then sterilized.

Patient selection, anaesthesia and aftercare are clinical decisions made by the treating doctor and are outside the scope of this article.

Buying a minor procedure tray

Ask the supplier for item-level lists, sizes and materials, and compare with your clinical protocols. Standardise the contents between clinics so that staff can move between sites without retraining. Verify current MOHAP, DHA or DOH requirements for the setting.

Beckfinity can help specify and quote an incision and drainage set from the REDA range for your emergency or surgical clinic.