Minimally invasive technique in treatment of complex, subcutaneous abscesses in children


      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.


      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.


      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.


      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.

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        • Seal J.
        • Glynn L.
        • Statter M.
        • et al.
        A high prevalence of methicillin-resistant Staphylococcus aureus among surgically drained soft-tissue infections in pediatric patients.
        Pediatr Surg Int. 2006; 22: 683-687
        • Faden H.
        • Rose R.
        • Lesse A.
        • et al.
        Clinical and molecular characteristics of staphylococcal skin abscesses in children.
        J Pediatr. 2007; 151: 700-703
        • Herold B.D.
        • Immergluck L.C.
        • Maranan M.C.
        • et al.
        Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk.
        JAMA. 1998; 279: 593-598
        • Frank A.L.
        • Marcinak J.F.
        • Mangat P.D.
        • et al.
        Community-acquired and clindamycin-susceptible methicillin-resistant Staphylococcus aureus in children.
        Pediatr Infect Dis. 1999; 18: 993-1000
        • O'Malley G.F.
        • Dominici P.
        • Giraldo P.
        • et al.
        Routine packing of simple cutaneous abscesses is painful and probably unnecessary.
        Acad Emerg Med. 2009; 16: 470-473
        • Halvorson G.D.
        • Halvorson J.E.
        • Iserson K.V.
        Abscess incision and drainage in the emergency department—part I.
        J Emerg Med. 1985; 3: 227-232
        • Sorensen C.C.
        Linear incision and curettage vs. deroofing and drainage in subcutaneous abscess. A randomized clinical trial.
        Acta Chir Scand. 1987; 153: 659-660
        • Abraham N.
        • Doudle M.
        • Carson P.
        Open versus closed surgical treatment of abscesses: a controlled clinical trial.
        Aust N Z J Surg. 1997; 67: 173-176
        • Philip R.S.
        A simplified method for the incision and drainage of abscesses.
        Am J Surg. 1978; 135: 721
        • Hankin A.
        • Everett W.W.
        Are antibiotics necessary after incision and drainage of a cutaneous abscess?.
        Ann Emerg Med. 2007; 50: 49-51
        • Lee M.C.
        • Rios A.M.
        • Fonseca Aten M.
        • et al.
        Management and outcome of children with skin and soft tissue abscesses caused by community-acquired methicillin-resistant Staphylococcus aureus.
        Pediatr Infect Dis J. 2004; 23: 123-127