Abstract
Purpose
The aim of this study was to expand on our previous report of 115 patients after more
than a decade-long experience using incision and loop drainage for pediatric subcutaneous
abscess management. This report comprises the largest consecutive series of pediatric
abscess patients from a single institution ever recorded.
Methods
A retrospective study was performed of all pediatric patients who underwent incision
and loop drainage of subcutaneous abscesses at our institution between January 2002
and December 2014.
Technique
Two sub 5 mm incisions were made at the periphery on the abscess. The abscess cavity was probed
to break down loculations and drain pus. The abscess cavity was irrigated with normal
saline. A loop drain was passed through one incision and brought out through the other.
A simple absorbent dressing was applied over the drain.
Results
Five hundred seventy-six consecutive patients underwent loop drainage procedures.
Mean values are as follows: age, 3.84 years; duration of symptoms, 6.17 days; postoperative length of stay (with 4 outliers excluded), 0.69 days; drain duration, 8.38 days; and number of postoperative visits, 1.28. Twenty-six patients had reoperations
(4.5%), 2 of which were planned staged excisions of pilonidal cysts and 1 because
of accidental home removal.
Conclusions
Micro-incisions and loop drainage is a safe and effective treatment modality for subcutaneous
abscesses in children. The findings eliminate the need for repetitive wound packing
and simplify postoperative wound care. Loop drainage offers shorter time to discharge,
lower recurrence rates, and minimal scarring. Additionally, there is expected cost
reduction. We recommend this minimally invasive procedure to be the standard of care
for subcutaneous abscesses in children.
Type of study
Treatment study – retrospective review.
Level of evidence
Level IV – case series with no comparison group.
Key words
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Article info
Publication history
Published online: January 07, 2017
Accepted:
December 26,
2016
Received in revised form:
December 16,
2016
Received:
October 3,
2016
Footnotes
☆This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
