Abstract
Open incision and drainage (I&D) and wound packing is accepted as the standard treatment for soft tissue abscesses. However, conventional I&D has a number of problems in practice which prompt us to improve the I&D methods that would minimize the pain associated with packing during dressing changes. In order to compare the pain associated with dressing changes in the conventional I&D group to the vacuum system group and the treatment time of both groups, we performed a randomized trial in pediatric patients between 0 and 18 years of age who are undergoing abscess drainage in the operating room from April 2011 to April 2015. Patients treated with open I&D (n = 648) were compared to those treated with placement of high-vacuum wound drainage system (n = 776) through the abscess cavities. Both groups received equivalent antibiotic treatment, and all patients were followed up in the outpatient clinics until the infection has been resolved. The mean FACES scale pain scores were significantly higher in the open I&D group than in the vacuum system group. The vacuum system group had a shorter length of stay and less need for community doctor or outpatient dressing changes than the open I&D group (p < 0.001). No recurrent abscesses were observed in the vacuum system group, and 10 patients in the open I&D group required another drainage at the exact same location.
Conclusion: High-vacuum wound drainage system was an efficient and safe alternative to the traditional I&D for community-acquired soft tissue abscesses with few complications in short term.
What is Known: • Open incision and drainage (I&D) followed by irrigation and wound packing is the standard treatment for soft tissue abscesses. • The painful daily packing may cause emotional trauma to the child and lead to an unwelcoming challenge to the caretakers and health care providers. |
What is New: • We modified the method of I&D by adding primary suturing of the wound and placement of a high-vacuum wound drainage system. • This technique was proved to be an efficient and safe alternative to the traditional I&D method for soft tissue abscesses with small complications in short term. |
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Abbreviations
- CHCMU:
-
Children’s Hospital of Chongqing Medical University
- CT:
-
Computed tomography
- EMRs:
-
Electronic medical records
- HIS:
-
Hospital information systems
- I&D:
-
Open incision and drainage
- LOS:
-
Length of stay
- NPWT:
-
Negative pressure wound therapy
- MRI:
-
Magnetic resonance imaging
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Author Chao Yang declares that he has no conflict of interest. Author Chang-chun Li declares that he has no conflict of interest. Author Jun Zhang declares that he has no conflict of interest. Author Xiang-ru Kong declares that he has no conflict of interest. Author Zhenzhen Zhao declares that he has no conflict of interest. Author Xiao-bin Deng declares that he has no conflict of interest. Author Liang Peng declares that he has no conflict of interest. Author Shan Wang declares that he has no conflict of interest. All authors have no financial relationship with the organization that sponsored the research.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from the medical guardian, and assent was obtained from children over 7 years of age.
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National Clinical Key Subject Construction Project([2013]544)
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Communicated by Jaan Toelen
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Yang, C., Wang, S., Li, Cc. et al. A high-vacuum wound drainage system reduces pain and length of treatment for pediatric soft tissue abscesses. Eur J Pediatr 176, 261–267 (2017). https://doi.org/10.1007/s00431-016-2835-2
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DOI: https://doi.org/10.1007/s00431-016-2835-2