An alternative to open incision and drainage for community-acquired soft tissue abscesses in children |
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Authors: | McNamara William F Hartin Charles W Escobar Mauricio A Yamout Sani Z Lau Stanley T Lee Yi-Horng |
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Affiliation: | a Department of Surgery, State University of New York at Buffalo, Buffalo, NY 14222, USAb Mary Bridge Children's Hospital & Health Center, Pediatric Surgical Services, PO Box 5299, MS: 311-W3-SUR, Tacoma, WA 98415-0299, USAc Department of Pediatric Surgery, The Women and Children's Hospital of Buffalo, Buffalo, NY 14222, USAd Kaiser Permanente Los Angeles Medical Center, Pediatric Surgery, Anaheim, CA 92807, USAe Division of Pediatric Surgery, Department of Surgery, University of Rochester Medical Center, Box SURG, Rochester, NY 14642, USA |
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Abstract: | BackgroundThe 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 DesignA 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.ResultsA 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.ConclusionsPlacement of a subcutaneous drain for community-acquired soft tissue abscesses in children is a safe and equally effective alternative to the traditional I&D. |
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Keywords: | Soft tissue infections Community-acquired MRSA Operative technique Abscess Incision and drainage Subcutaneous drain |
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