title: The LOOP technique: a novel incision and drainage technique in the treatment of skin abscesses in a pediatric ED.
abstract: OBJECTIVE
  This study assesses outcome in pediatric patients with skin abscess using the LOOP compared to the standard incision and drainage (I&D) with packing method.
  
  
  METHODS
  This retrospective study used ICD-9 codes to identify pediatric patients aged 0 to 17 years with a skin abscess presenting to a level I pediatric trauma emergency department (ED). Patients requiring surgical debridement were excluded; as were patients with abscesses on the face, scalp, hands or feet. The primary outcome was failure rate, defined as those requiring admission, intravenous antibiotics, or repeat drainage.
  
  
  RESULTS
  Over a 1-year period there were 233 pediatric abscesses identified: 79 cases (34%) treated with the LOOP technique and 154 cases with standard I&D (66%). The overall mean age of patients was 6.2 yrs: children in the LOOP group were younger than those in the standard group, 4.4 vs 7.1 years respectively (P=.001). Abscess location also differed between the two groups; however they had a similar gender distribution and mean temperature. Of the cases identified by chart review, clinical outcome could be assessed in 143 patients (61%): 52 (36%) patients with LOOP vs 91 (64%) with I&D. Failure rate was 1.4% in the LOOP group and 10.5% in the standard I&D (P<.030).
  
  
  CONCLUSIONS
  There was a significant difference in failure rate between the LOOP and the standard I&D groups. A prospective randomized trial is needed to confirm these results, but this novel technique shows promise as an alternative to I&D with packing in the management of skin abscesses in pediatric ED patients.
authors.affiliation: Orlando Regional Medical Center, Orlando, FL. Electronic address: jladde@hotmail.com.
authors.forename: Jay G
authors.initials: JG
authors.lastname: Ladde
authors.affiliation: Orlando Regional Medical Center, Orlando, FL. Electronic address: sybaker@gmail.com.
authors.forename: Sara
authors.initials: S
authors.lastname: Baker
authors.affiliation: Orlando Regional Medical Center, Orlando, FL. Electronic address: 4076236190@myairmail.com.
authors.forename: C Neil
authors.initials: CN
authors.lastname: Rodgers
authors.affiliation: Orlando Regional Medical Center, Orlando, FL. Electronic address: lpstat@aol.com.
authors.forename: Linda
authors.initials: L
authors.lastname: Papa
mesh_terms: D000038:Abscess / Q000601:surgery*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012874:Skin Diseases, Infectious / Q000601:surgery*; D013536:Suture Techniques; D017211:Treatment Failure; D016896:Treatment Outcome