Cutaneous Abcesses in ED Management

“Cutaneous abscesses have traditionally been treated with incision and drainage (I&D) and left to heal by secondary closure.” The enclosed article published in the Academic Emergency Medicine Journal presents research where  the objective “was to compare the healing rates of cutaneous abscesses following I&D after primary or secondary closure.

Whether all incised and drained abscesses in the ED require routine packing has recently been challenged by a study demonstrating similar healing rates and less pain when such abscesses were not packed. Less invasive methods of draining simple cutaneous abscesses in the ED have also received recent attention. In a study comparing ultra sonographically guided needle aspiration and conventional I&D for skin abscesses in the ED, Gaspari et al. concluded that needle aspiration, even when guided by ultrasound, was insufficient due to low success rates. In contrast with I&D, needle aspiration does not allow breakdown of abscess loculations or irrigation, both of which were performed in “this  study,” even though incision length was relatively short”.

The finding of this study found” rates of wound healing and treatment failure following I&D of simple abscesses in the ED are similar after primary or secondary closure.”

Cutaneous Abcesses ED PDF

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