A comparison of traditional incision and drainage versus catheter drainage of soft tissue abscesses in children.
OBJECTIVE
Soft tissue infections are increasingly being seen for surgical management, which is associated with painful dressing changes, lost days at school, time away from family, and scarring, which can have a great impact on both child and caretaker. We postulated that a drainage technique using a modified Pezzar catheter would be associated with shorter hospital stays and less wound care.


METHODS
A consecutive series of 400 children with soft tissue abscesses was evaluated from April 2007 to October 2008. Children were managed according to the operating surgeon's preference. Children remained in the hospital until they were afebrile and the wounds could be adequately managed at home. Drains were removed 1 week after surgery in clinic.


RESULTS
There were no treatment failures. Three hundred twenty-two children were managed with standard incision and drainage (I&D) and 78 patients with catheter drainage. Twenty-two children in the catheter drainage group (28%) required hospitalization of greater than 1 day compared with 151 children (47%) in the I&D group (P = .001, Fisher exact test). Thirty-four percent of the children managed with I&D required packing at home, which was required in none of the patients managed with catheter drainage. Patient age, catheter drainage, and site of the lesion were associated independently with shorter hospital stays.


CONCLUSIONS
We conclude that catheter drainage of soft tissue abscesses in children is safe and effective. Catheter drainage is associated with a decreased hospital stay. Other factors related to shorter hospital stays include age of the patient and the site of soft tissue abscess.
Department of Pediatric Surgery, Children's Medical Center, UT Southwestern, Dallas, TX, USA. adam.alder@utsouthwestern.edu
Adam C
AC
Alder
Jill
J
Thornton
Kim
K
McHard
Linda
L
Buckins
Robert
R
Barber
Michael A
MA
Skinner
D000038:Abscess / Q000188:drug therapy / Q000601:surgery*; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D057785:Catheters; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D012086:Reoperation / Q000706:statistics & numerical data; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing
D000900:Anti-Bacterial Agents