Abstract
The rising prevalence of community-acquired, methicillin-resistant Staphylococcus aureus (MRSA) has correlated with an escalating number of complex, subcutaneous abscesses
in pediatric patients. The purpose of this study was to present a novel technique
and early outcome results for the minimally invasive drainage of complex, subcutaneous
abscesses.
Methods
Patients' outcomes from the treatment of complex, subcutaneous abscesses were retrospectively
reviewed under institutional review board approval from July 2006 to August 2007 at
2 independent, tertiary care pediatric hospitals. Data on patients' demographics,
length of hospital stay, and length of treatment were collected, along with analysis
of the isolated organisms.
The operative technique uses drainage of the abscess through peripheral stab incisions.
Cavity debridement and irrigation is followed by placement of a vessel-loop drain
through the drainage incisions. Topical wound care without packing is performed twice
a day. Drain removal follows resolution of cellulitis and drainage.
Results
One hundred twenty-eight patients were treated over a 14-month period. The ratio of
females to males was 1.25:1. Average patient age was 51.5 months (median, 21 months)
and ranged from 5 weeks to 18 years. The average length of hospital stay was 1.5 days,
though 30 patients were treated on an outpatient basis. Methicillin-resistant Staphylococcus aureus was identified in 76% of the cultured specimens. Average length of drain use was
9 days (range, 5-29 days). There were no local recurrences of subcutaneous abscesses.
There was no morbidity related to the drainage procedures.
Conclusion
We present a successful technique for the drainage and treatment of complex abscesses
in children with limited, postoperative wound care and no morbidity or recurrence.
Key words
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Article info
Publication history
Accepted:
March 22,
2010
Received in revised form:
February 12,
2010
Received:
January 6,
2010
Footnotes
☆Presented at Pacific Association of Pediatric Surgeons 41st Annual Meeting June 30-July 3, 2008, Jackson Lake, Wyoming.
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
