Gottlieb M, Schmitz G, Peksa GD, et al.
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. Date of publication 2021 Mar 1;volume 28(3):346-354.
1. Acad Emerg Med. 2021 Mar;28(3):346-354. doi: 10.1111/acem.14151. Epub 2020 Nov
9.
Comparison of the Loop Technique With Incision and Drainage for Skin and Soft
Tissue Abscesses: A Systematic Review and Meta-analysis.
Gottlieb M(1), Schmitz G(2), Peksa GD(1).
Author information:
(1)From the, Department of Emergency Medicine, Rush University Medical Center,
Chicago, IL, USA.
(2)and the, Department of Military and Emergency Medicine, Uniformed Services
University, Bethesda, MD, USA.
BACKGROUND: Cutaneous abscesses are common presentations to the emergency
department. While the primary treatment for most abscesses is conventional
incision and drainage (CID), this is painful and can lead to multiple return
visits. The loop drainage technique (LDT) has been proposed as an alternate,
less-invasive approach to abscess management. The primary outcome of this study
was to compare LDT with CID for skin and soft tissue abscesses.
METHODS: PubMed, Scopus, CINAHL, LILACS, Google Scholar, the Cochrane Database
of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and
bibliographies of selected articles were assessed for all retrospective,
prospective observational, and randomized controlled trials comparing treatment
failures between LDT and CID among patients with skin and soft tissue abscesses.
Data were dual extracted into a predefined worksheet and quality analysis was
performed using the Cochrane Risk of Bias tool or the Newcastle-Ottawa scale.
Data were summarized and presented as odds ratios (ORs) with 95% confidence
intervals (CIs). Subgroup analyses were performed for adult and pediatric
patients.
RESULTS: A total of 1,374 studies were identified with eight studies (n = 910
patients) selected for inclusion. Overall, CID failed in 69 of 487 patients
(14.17%), while LDT failed in 35 of 423 patients (8.27%). There was an OR of
2.02 (95% CI = 1.29 to 3.18) in favor of higher failures in the CID group. This
finding remained consistent with only randomized controlled trials (OR = 1.75,
95% CI = 1.07 to 2.86), but no difference was identified in the adult or
pediatric subgroups.
CONCLUSION: The LDT was associated with reduced treatment failures when compared
with CID. Future studies should further assess the impact on pain, cosmetic
outcomes, and health care costs.
© 2020 by the Society for Academic Emergency Medicine.
DOI: 10.1111/acem.14151
PMID: 33037713 [Indexed for MEDLINE]
