Name of the Procedure

Incision and drainage, upper arm or elbow area; bursa
Common Name: Bursal Incision and Drainage

Summary

This procedure involves making a small cut (incision) in the skin overlying the bursa—a fluid-filled sac near the elbow or upper arm—and draining the accumulated fluid, pus, or debris to relieve pain and reduce infection or inflammation.

Purpose

The main condition this procedure addresses is bursitis, which is the inflammation of the bursa due to infection or chronic irritation. The goal is to alleviate pain, reduce swelling, and prevent the spread of infection, allowing for a quicker recovery and improved joint function.

Indications

• Persistent pain and swelling in the upper arm or elbow area.
• Signs of infection in the bursa (e.g., redness, warmth, fever).
• Failure of conservative treatments like medications and rest.
• Presence of an abscess in the bursa.

Preparation

• Fasting may not be necessary but follow your doctor's specific instructions.
• Inform your doctor of any medications or allergies.
• Pre-procedural imaging tests like an ultrasound may be conducted to confirm the diagnosis.

Procedure Description

1. The patient is positioned comfortably, and the affected area is sterilized.
2. Local anesthesia is administered to numb the area.
3. A small incision is made over the bursa.
4. Fluid, pus, or debris is gently drained out.
5. The area is irrigated with a saline solution to ensure complete drainage.
6. The incision may be left open to allow for continuous drainage or closed with sutures.
7. A dressing is applied to protect the area.

Duration

The entire procedure usually takes about 30 to 45 minutes.

Setting

The procedure is often performed in an outpatient clinic or a surgical center.

Personnel

• Surgeon or specialized physician.
• Nurses to assist with the procedure and patient care.
• Anesthesiologist, if sedation is used.

Risks and Complications

• Infection at the incision site.
• Bleeding or hematoma.
• Localized pain or discomfort.
• Rarely, injury to surrounding tissues or nerves.
• Potential scarring.

Benefits

• Rapid relief from pain and swelling.
• Decreased risk of spreading infection.
• Quick improvement in joint function and mobility.
• Minimal downtime compared to more invasive interventions.

Recovery

• Keep the incision site clean and dry.
• Follow the doctor's instructions on changing dressings and wound care.
• Monitor for signs of infection such as increased redness or fever.
• Typically, recovery can span from a few days to a week, depending on the severity of the initial condition.
• Physical activity may be limited initially, with a gradual return to normal activities.

Alternatives

• Oral or injectable antibiotics for infection.
• Corticosteroid injections to reduce inflammation.
• Aspiration of the bursa with a needle.
• Conservative measures like rest, icing, and non-steroidal anti-inflammatory drugs (NSAIDs).
• Surgery may be considered in chronic or recurrent cases.

Patient Experience

During the procedure, the patient will likely feel pressure or slight discomfort but should not experience significant pain due to local anesthesia. Post-procedure, soreness or minor pain at the incision site is common and can be managed with prescribed pain medications. The patient should feel gradual improvement over the following days and experience significant relief from initial symptoms.