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Randomized Controlled Trial
Irrigation of Cutaneous Abscesses Does Not Improve Treatment Success.
- Brian Chinnock and Gregory W Hendey.
- Department of Emergency Medicine, UCSF-Fresno Medical Education Program, Fresno, CA. Electronic address: bchinnock@fresno.ucsf.edu.
- Ann Emerg Med. 2016 Mar 1; 67 (3): 379-83.
Study ObjectiveIrrigation of the cutaneous abscess cavity is often described as a standard part of incision and drainage despite no randomized, controlled studies showing benefit. Our goal is to determine whether irrigation of a cutaneous abscess during incision and drainage in the emergency department (ED) decreases the need for further intervention within 30 days compared with no irrigation.MethodsWe performed a single-center, prospective, randomized, nonblinded study of ED patients receiving an incision and drainage for cutaneous abscess, randomized to irrigation or no irrigation. Patient characteristics and postprocedure pain visual analog scale score were obtained. Thirty-day telephone follow-up was conducted with a standardized data form examining need for further intervention, which was defined as repeated incision and drainage, antibiotic change, or abscess-related hospital admission.ResultsOf 209 enrolled patients, 187 completed follow-up. The irrigation and no-irrigation groups were similar with respect to diabetes, immunocompromise, fever, abscess size, cellulitis, and abscess location, but the irrigation group was younger (mean age 36 versus 40 years) and more often treated with packing (89% versus 75%) and outpatient antibiotics (91% versus 73%). The need for further intervention was not different in the irrigation (15%) and no-irrigation (13%) groups (difference 2%; 95% confidence interval -8% to 12%). There was no difference in pain visual analog scale scores (5.6 versus 5.7; difference 0.1; 95% confidence interval -0.7 to 0.9).ConclusionAlthough there were baseline differences between groups, irrigation of the abscess cavity during incision and drainage did not decrease the need for further intervention.Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
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