title: Same-day discharge after incision and drainage of soft-tissue abscess in diaper-age children is safe and effective.
abstract: OBJECTIVE
  Many pediatric centers admit patients following incision and drainage (I&D) of soft-tissue abscesses. The purpose of this study is to assess the safety and efficacy of the same-day discharge following I&D.
  
  
  METHODS
  Retrospective review was performed of children aged 3 months-4 years who underwent operative I&D of an abscess followed by same-day discharge. Patients receiving antibiotics within 2 weeks of presentation were excluded. Treatment failure was defined as readmission or repeat procedure related to the initial abscess. Statistical analysis was performed using Wilcoxon Rank-Sum and Fisher's Exact tests.
  
  
  RESULTS
  There were 442 procedures performed in 408 patients. Mean age was 1.8 years. Fever was noted in 25.8%. Of those who had a white blood cell (WBC) count drawn, 59.7% had leukocytosis. Mean time from procedure to discharge was 2.3 h, and 85.0% were discharged with oral antibiotics. Treatment failure occurred in four (0.9%) and ten (2.3%) patients at 14 and 30 days, respectively. Mean WBC count was higher in the 14-day treatment failure group (24.1 versus 16.3; p = 0.10). In patients with leukocytosis, there were 2 (1.4%) treatment failures compared to none in those without leukocytosis.
  
  
  CONCLUSIONS
  Same-day discharge after I&D of abscess in diaper-age children is safe and effective.
authors.affiliation: Department of Pediatric Surgery, Akron Children's Hospital, Akron, OH, USA.
authors.forename: Ian C
authors.initials: IC
authors.lastname: Glenn
authors.affiliation: Department of Pediatric Surgery, Akron Children's Hospital, Akron, OH, USA.
authors.forename: Nicholas E
authors.initials: NE
authors.lastname: Bruns
authors.affiliation: Department of Pediatric Surgery, Akron Children's Hospital, Akron, OH, USA.
authors.forename: Domenic
authors.initials: D
authors.lastname: Craner
authors.affiliation: Department of Pediatric Surgery, Akron Children's Hospital, Akron, OH, USA.
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Gibbons
authors.affiliation: Department of Pediatric Surgery, Akron Children's Hospital, Akron, OH, USA.
authors.forename: Danial
authors.initials: D
authors.lastname: Hayek
authors.affiliation: Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, OH, USA.
authors.forename: Neil L
authors.initials: NL
authors.lastname: McNinch
authors.affiliation: Department of Pediatric Surgery, Akron Children's Hospital, Akron, OH, USA.
authors.forename: Oliver S
authors.initials: OS
authors.lastname: Soldes
authors.affiliation: Department of Pediatric Surgery, Akron Children's Hospital, Akron, OH, USA. tponsky@gmail.com.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Ponsky
mesh_terms: D000038:Abscess / Q000150:complications / Q000601:surgery*; D000553:Ambulatory Care / Q000379:methods*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002675:Child, Preschool; D004322:Drainage / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005334:Fever / Q000150:complications; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Abscess; Antibiotic stewardship; Antibiotics; Skin and soft-tissue infection