Abstract
Background
The continually rising incidence of soft tissue abscesses in children has prompted
us to seek an alternative to the traditional open incision and drainage (I&D) that
would minimize the pain associated with packing during dressing changes and eliminate
the need for home nursing care.
Study Design
A retrospective review of all patients with soft tissue abscesses from November 2007
to June 2008 was conducted after institutional review board approval. Patients who
were treated with open I&D were compared to those treated with placement of subcutaneous
drains through the abscess cavities. Both groups received equivalent antibiotic treatment,
and all patients were followed in outpatient clinics until infection resolved. The
demographics, presenting temperature, culture results, and outcomes were compared
between these 2 groups.
Results
A total of 219 patients were identified; 134 of them underwent open I&D, whereas 85
were treated with subcutaneous drains. The demographics, anatomical location of the
abscesses, and bacteriology were comparable between the 2 groups. There were equal
number of patients in each group who presented with fever initially. Of those treated
with open I&D, 4 had metachronous recurring abscesses within the same anatomical region
and 1 patient required an additional procedure because of incomplete drainage. There
were no recurrences or incomplete drainages in the subcutaneous drain group. The cosmetic
appearance of the healed wound from subcutaneous drain placement during the immediate
follow-up period is better than that of an open I&D.
Conclusions
Placement of a subcutaneous drain for community-acquired soft tissue abscesses in
children is a safe and equally effective alternative to the traditional I&D.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pediatric SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The treatment of acute superficial abscesses: a prospective clinical trial.Br J Surg. 1977; 64: 264-266
- Treatment of cutaneous abscess: a double-blind clinical study.Ann Emerg Med. 1985; 14: 15-19
- Methicillin-resistant S. aureus infections among patients in the emergency department.N Engl J Med. 2006; 355: 666-674
- Clinical and molecular characteristics of staphylococcal skin abscesses in children.J Pediatr. 2007; 151: 700-703
- Incision and drainage procedures: soft tissue abscesses in the emergency service.Emerg Med Clin North Am. 1986; 4: 527-542
- Practice guidelines for the diagnosis and management of skin and soft-tissue infections.Clin Infect Dis. 2005; 41: 1373-1406
- Videos in clinical medicine. Abscess incision and drainage.N Engl J Med. 2007; 357: e20
- A review of community-associated methicillin-resistant Staphylococcus aureus skin and soft tissue infections.Pediatr Infect Dis J. 2008; 27: 1-7
- Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk.Jama. 1998; 279: 593-598
- Are antibiotics necessary after incision and drainage of a cutaneous abscess?.Ann Emerg Med. 2007; 50: 49-51
- Natural history of community-acquired methicillin-resistant Staphylococcus aureus colonization and infection in soldiers.Clin Infect Dis. 2004 Oct 1; 39: 971-979
Article info
Publication history
Accepted:
August 11,
2010
Received in revised form:
August 10,
2010
Received:
January 15,
2010
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
