Loop and drain technique for subcutaneous abscess: a safe minimally invasive procedure in an adult population.
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.


CONCLUSIONS
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.
Department of General Surgery, Shoalhaven District Memorial Hospital, Nowra, New South Wales, Australia.
Rafael
R
Gaszynski
Department of General Surgery, Lismore General Hospital, Lismore, New South Wales, Australia.
Gratian
G
Punch
Department of General Surgery, Shoalhaven District Memorial Hospital, Nowra, New South Wales, Australia.
Kurt
K
Verschuer
D000038:Abscess / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001458:Bandages; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012871:Skin Diseases / Q000601:surgery*; D055815:Young Adult
D000900:Anti-Bacterial Agents