Topical anesthetic cream is associated with spontaneous cutaneous abscess drainage in children.
OBJECTIVE
The objective of the study was to determine whether use of topical anesthetic cream increases spontaneous drainage of skin abscesses and reduces the need for procedural sedation.


METHODS
A retrospective multicenter cohort study from 3 academic pediatric emergency departments was conducted for randomly selected children with a cutaneous abscess in 2007. Children up to 18 years of age were eligible if they had a skin abscess at presentation. Demographics, abscess characteristics, and use of a topical analgesic were obtained from medical records.


RESULTS
Of 300 subjects, 58% were female and the median age was 7.8 years (interquartile range, 2-15 years). Mean abscess size was 3.5 ± 2.4 cm, most commonly located on the lower extremity (30%), buttocks (24%), and face (12%). A drainage procedure was required in 178 children, of whom 9 underwent drainage in the operating room. Of the remaining 169 children who underwent emergency department-based drainage, 110 (65%) had a topical anesthetic agent with an occlusive dressing placed on their abscess before drainage. Use of a topical anesthetic resulted in spontaneous abscess drainage in 26 patients, of whom 3 no longer required any further intervention. In the 166 patients who underwent additional manipulation, procedural sedation was required in 26 (24%) of those who had application of a topical anesthetic and in 24 (41%) of those who had no topical anesthetic (odds ratio, 0.45; 95% confidence interval, 0.23-0.89).


CONCLUSIONS
Topical anesthetic cream application before drainage procedures promotes spontaneous drainage and decreases the need for procedural sedation for pediatric cutaneous abscess patients.
Department of Emergency Medicine, UMDNJ-RWJMS at Camden, One Cooper Plaza, Camden, NJ 08103, USA.
Tara
T
Cassidy-Smith
Rakesh D
RD
Mistry
Christopher J
CJ
Russo
Kathryn
K
McCans
Naomi
N
Brown
Lisa M
LM
Capano-Wehrle
Lisa A
LA
Drago
Patty A
PA
Vitale
Brigitte M
BM
Baumann
D000038:Abscess / Q000188:drug therapy*; D000293:Adolescent; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D004322:Drainage / Q000379:methods*; D004636:Emergency Service, Hospital; D004643:Emollients / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012871:Skin Diseases / Q000188:drug therapy*
D000779:Anesthetics, Local; D004643:Emollients