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Am J Emerg Med. 2015 Feb;33(2):271-6. doi: 10.1016/j.ajem.2014.10.014. Epub 2014 Oct 16.

The LOOP technique: a novel incision and drainage technique in the treatment of skin abscesses in a pediatric ED.

Author information

1
Orlando Regional Medical Center, Orlando, FL. Electronic address: jladde@hotmail.com.
2
Orlando Regional Medical Center, Orlando, FL. Electronic address: sybaker@gmail.com.
3
Orlando Regional Medical Center, Orlando, FL. Electronic address: 4076236190@myairmail.com.
4
Orlando Regional Medical Center, Orlando, FL. Electronic address: lpstat@aol.com.

Abstract

OBJECTIVE:

This study assesses outcome in pediatric patients with skin abscess using the LOOP compared to the standard incision and drainage (I&D) with packing method.

METHODS:

This retrospective study used ICD-9 codes to identify pediatric patients aged 0 to 17 years with a skin abscess presenting to a level I pediatric trauma emergency department (ED). Patients requiring surgical debridement were excluded; as were patients with abscesses on the face, scalp, hands or feet. The primary outcome was failure rate, defined as those requiring admission, intravenous antibiotics, or repeat drainage.

RESULTS:

Over a 1-year period there were 233 pediatric abscesses identified: 79 cases (34%) treated with the LOOP technique and 154 cases with standard I&D (66%). The overall mean age of patients was 6.2 yrs: children in the LOOP group were younger than those in the standard group, 4.4 vs 7.1 years respectively (P=.001). Abscess location also differed between the two groups; however they had a similar gender distribution and mean temperature. Of the cases identified by chart review, clinical outcome could be assessed in 143 patients (61%): 52 (36%) patients with LOOP vs 91 (64%) with I&D. Failure rate was 1.4% in the LOOP group and 10.5% in the standard I&D (P<.030).

CONCLUSION:

There was a significant difference in failure rate between the LOOP and the standard I&D groups. A prospective randomized trial is needed to confirm these results, but this novel technique shows promise as an alternative to I&D with packing in the management of skin abscesses in pediatric ED patients.

PMID:
25435407
DOI:
10.1016/j.ajem.2014.10.014
[Indexed for MEDLINE]

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