Leinwand M, Downing M, Slater D, Beck M, Burton K, Moyer D, et al.
Journal of pediatric surgery. Date of publication 2013 Sep 1;volume 48(9):1962-5.
1. J Pediatr Surg. 2013 Sep;48(9):1962-5. doi: 10.1016/j.jpedsurg.2013.01.027.
Incision and drainage of subcutaneous abscesses without the use of packing.
Leinwand M(1), Downing M, Slater D, Beck M, Burton K, Moyer D.
Author information:
(1)Department of Pediatric Surgery, Bronson Children's Hospital, Kalamazoo, MI
49007, USA. Electronic address: leinwanm@bronsonhg.org.
PURPOSE: The classic intervention for subcutaneous abscesses is incision and
drainage followed by wound packing. This is thought to aid hemostasis, and
prevent reorganization of the abscess. Removal of packing material may be
painful and anxiety provoking. We sought to determine whether packing could be
omitted with equal efficacy.
METHODS: One hundred pediatric patients with subcutaneous abscesses were
enrolled between May, 2008 and December, 2010. All underwent incision and
drainage, then seven days of oral antibiotics and warm soaks. Patients were
randomized to the packing group (PG) or non-packing group (NPG). Packing was
removed 24h after the procedure. Patients were excluded if: 1)
diabetic/immunosuppressed, 2) the abscess was perianal or pilonidal, or 3) the
abscess was secondary to a previous operation. Patients were evaluated in clinic
if recurrence was suspected during follow-up calls on postoperative days seven
and 30.
RESULTS: Eighty-five patients completed the study (43 PG/42 NPG). The two groups
were not statistically different with respect to initial parameters, recurrent
abscesses (one in each group), or MRSA incidence (81.4% PG/85.7% NPG).
CONCLUSION: Incision and drainage of subcutaneous abscesses without the use of
packing is a safe and effective technique. This approach omits a traditional,
but painful and anxiety provoking, component of therapy.
Copyright © 2013 Elsevier Inc. All rights reserved.
DOI: 10.1016/j.jpedsurg.2013.01.027
PMID: 24074675 [Indexed for MEDLINE]
