The aim of the study was to evaluate outcomes after a minimally invasive approach
to pediatric subcutaneous abscess management as a replacement for wide exposure, debridement,
and repetitive packing.
A retrospective study was performed of all children who underwent incision and loop
drainage for subcutaneous abscesses between January 2002 and October 2007 at our institution.
Two mini incisions, 4-5 mm each, were made on the abscess, as far apart as possible.
Abscess was probed, and pus was drained. Abscess was irrigated with normal saline;
a loop drain was passed through one incision, brought out through the other, and tied
to itself. An absorbent dressing was applied over the loop and changed regularly.
One hundred fifteen patients underwent drainage procedures as described; 5 patients
had multiple abscesses. Mean values (range) are as follows: age, 4.25 years (19 days
to 20.5 years); duration of symptoms, 7.8 days (1-42 days); length of hospital stay,
3 days (1-39 days); duration of procedure, 10.8 minutes (4-43 minutes); drain duration,
10.4 days (3-24 days); and number of postoperative visits, 1.8 (1-17). Bacterial culture
data were available for 101 patients. Of these, 50% had methicillin-resistant Staphylococcus aureus, 26% had methicillin-sensitive Staphylococcus aureus, and 9% streptococcal species. Of the 115 patients, 5 had pilonidal abscesses, 1
required reoperation for persistent drainage, and 1 had a planned staged excision.
Of the remaining 110 patients, 6 (5.5%) required reoperation—4 with loop drains and
2 with incision and packing with complete healing.
The use of loop drains proved safe and effective in the treatment of subcutaneous
abscesses in children. Eliminating the need for repetitive and cumbersome wound packing
simplifies postoperative wound care. Furthermore, there is an expected cost savings
with this technique given the decreased need for wound care materials and professional
postoperative home health services. We recommend this minimally invasive technique
as the treatment of choice for subcutaneous abscesses in children and consider it
the standard of care in our facility.