Loop Drainage of Subcutaneous Abscesses in Pediatric Patients
ABSTRACT
Background: Subcutaneous abscesses are increasingly common among the pediatric population in the United States. They require drainage as a means of treatment, as antibiotics alone cannot resolve the infection. The current standard of care is open incision and drainage, which often requires packing the open wound with sterile material, then removing the packing within 24-48 hours. This can be very painful, especially in pediatric populations. An alternative treatment is loop drainage, which involves making two smaller incisions and placing a drain in the wound as opposed to packing. This review compares loop drainage to open drainage in regards to cost, hospital length of stay, and rate of procedure failure.
Methods: An extensive literature search was done using MEDLINE-PubMed, CINAHL, Health & Medical Complete, and Web of Science. Keywords used included: abscess and loop drainage. All articles were assessed using GRADE criteria.
Results: A total of 143 articles were narrowed down to three primary articles that directly compared the two methods of abscess drainage. All three articles were cohort retrospective studies. The studies found that loop drainage is just as effective as open drainage, but with a decreased cost, hospital length of stay, and reduced incidence of procedure failure. Due to the nature of the three studies, they were considered to have low quality evidence and a future randomized control study needs to be done to confirm the results.
Conclusion: In pediatric patients with subcutaneous abscesses, research shows that loop drainage may be a better option when compared to open drainage results. This is a promising technique with the potential to change the standard of care for subcutaneous abscesses, especially in patient populations where medical cost is a concern.
Keywords: abscess, loop drainage, loop technique, minimally invasive drainage
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REVIEWED STUDIES:
McNamara WF, Hartin CWJ, Escobar MA, Yamout SZ, Lau ST, Lee Y. An alternative to open incision and drainage for community-acquired soft tissue abscesses in children. J Pediatr Surg. 2011;46:502-506.
Ladde JG, Baker S, Rodgers CN, Papa L. The LOOP technique: a novel incision and drainage technique in the treatment of skin abscesses in a pediatric ED. Am J Emerg Med. 2015;33:271-276.
Wendling P. Novel Technique Improved Skin Abscess Drainage. Elsevier Global Medical News [serial online]. 2009:February 23, 2016.
AUTHOR: Kacie Hamreus is currently completing her second year in the School of PA Studies at Pacific University, Oregon. She will graduate with an MS degree in August, 2016.