Loop and drain technique for subcutaneous abscess: a safe minimally invasive procedure in an adult population. Issue 1 (12th September 2016)

• Record Type: Journal Article
• Authors: Gaszynski, Rafael; Punch, Gratian; Verschuer, Kurt
• Is Part Of: ANZ journal of surgery. Volume 88:Issue 1/2(2018)
• Page Start: 87
• Page End: 90
• Publication Date: 2016-09-12
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.13709
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract : Background: This study evaluated the safety, efficacy and compliance of an emerging technique for managing complex subcutaneous abscesses in an adult population (≥16 years). Methods: A retrospective review of prospectively collected data between April and October 2015 at a rural hospital comparing conventional incision drainage (CID) and repetitive packing to the minimal incision, irrigation, loop and drain technique (LDT). LDT method was consistent with previous publications, being ≤5 mm incisions at abscess edges, irrigation and passage of a VessiLoop through the cavity and then secured above the skin. The loop remained in situ until resolution. Both groups had empirical oral antibiotics. Results: Sixty‐three patients required intervention for complex subcutaneous abscess: CID group had 27 patients and LDT had 36 patients. The mean age of CID group was 43.9 years (range: 16–86 years), all required intervention in theatre with 10 patients lost to follow‐up (37%) and the remaining 17 required a mean of 11.8 (range: 1–17) care visits. The mean age of LDT group was 34.9 years (range: 16–62 years), 11 completed intervention in ED under local anaesthetic (30%) and 27 required general anaesthesia. Compliance to follow‐up clinic was 100%: 27 seen once at 10–14 days with loop removal and nine were seen a second time to complete care. There were no re‐operations. Conclusion: This is the first LDT data in adults and proves it is safe and effective. It saves operating theatre time with 30% of LDT treated in the Emergency Department and ensures excellent follow‐up compliance as patients return for VessiLoop removal. Healthcare burden is greatly reduced using LDT; most patients require only one review at 10–14 days.