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Abscess drain management

Management of abscess drainage catheters:

1) Criteria for catheter removal include resolution of clinical signs of infection AND daily patent catheter output <20 mL, (1) AND repeat imaging showing resolution of the cavity. If all of these criteria are met, the drainage catheter can be cut on the back end (which releases the pig tail) and pulled out.

2) On follow-up imaging, complex cavities may not be completely evacuated despite an appropriately placed and patent drainage catheter. This is usually due to internal loculations, clots, or debris. If there is a question for need of drainage catheter up-sizing, please contact the Interventional Radiology Service

3) To maintain catheter patency, it is recommended to flush the catheter with 10 mL of saline every 8 hours, (1) followed by continued drainage.

Reference:
(1) Cronin C G, Gervais D A, Castillo C F, Mueller P R, Arellano R S. Interventional radiology in the management of abdominal collections after distal pancreatectomy: a retrospective review. AJR Am J Roentgenol. 2011;197(1):241–246.

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