How to Drain a Felon

A felon is an infection of the pulp space of a distal finger/thumb that usually occurs secondary to minor trauma.  Prompt treatment is required as there is risk of spread to the flexor tendon sheath and even osteomyelitis.


  • Digital block
  • Incision and drainage with unilateral longitudinal approach to avoid damage to neurovascular structures and release the vertical septae
    • Preferred approach as it will limit loss of sensation to finger pad
    • Typically on ulnar side (unless little finger)
    • Other types of incisions may be made for more severe infections
  • Irrigation
  • Dry dressing
  • Wound check within 2 days
  • Oral antibiotics


  • Evidence-Based Management of Acute Hand Injuries in the Emergency Department. Emergency Medicine Practice. December 2014.