Conventional incision and drainage versus incision and drainage with primary closure in acute abscess: a prospective study
DOI:
https://doi.org/10.18203/2349-2902.isj20175911Keywords:
Acute abscesses, Incision and drainage, Primary closure, Wound healingAbstract
Background: An abscess is a common surgical condition. Abscesses may occur anywhere in the body. Surgical treatment of subcutaneous and soft tissue abscesses includes percutaneous aspiration, incision and drainage without primary closure, incision and drainage with primary closure with drain. The present study was planned to compare conventional method of incision and drainage with incision and drainage with primary closure in cases of acute -abscesses.
Methods: A total of 100 patients with acute abscesses were included in the study and randomized into 2 groups with 50 patients in each group. The present study was carried out to compare the conventional method of incision and drainage with incision and drainage with primary closure of the wounds in acute abscesses with regards to wound healing, post- operative pain, duration of hospital stays and recurrence rates.
Results: Wound healing was significantly faster in incision and drainage with primary closure (9.18±0.941days) as compared to conventional method of incision and drainage (16.66±1.944 days) [p <0.05]. Mean hospital stay with convention method of incision and drainage was 7.12±0.718 days and with primary closure was 4.0±0.728days (p <0.05). Mean VAS was significantly less in primary closure as compared with conventional method. Decreasing trend in VAS was observed on day 3, day 5 and day 7 (p value 0.000). Recurrence rate of an abscess was seen in 5 cases in conventional method and 2 cases in primary closure (p >0.05).
Conclusions: Author have observed a significant difference noted in time taken for wound healing, postoperative pain, hospital stay and recurrence rate between two groups.
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References
Townsend CM. Surgical Infections and Choice of Antibiotics. Sabiston Textbook of Surgery: the biological basis of modern surgical practice. Saunders Elsevier, Philadelphia; 2007:299-327.
Edino ST, Ihezue CH, Obekpa PO. Outcome of primary closure of incised acute soft tissue abscesses. Niger Postgrad Med J. 2001;8:32-6.
Lamont P. Surgical Infection. In: Williams NS, Bulstrode C, O’connell P. Bailey and Love’s Short Practice of Surgery, 26th Ed. CRC, London; 2013:53-55.
Thomas W. Basic surgical skills and anastomosis. In: Williams NS, Bulstrode C, O’connell P. Bailey and Love’s Short Practice of Surgery, 26th Ed. CRC, London; 2013;53-55.
Ruiz LP, Strain EC, John G. The substance abuse handbook. Wolters Kluwer Health/Lippincott Williams and Wilkins Philadelphia; 2007:373.
Efem DE. Breast abscesses in Nigeria; Lactational versus non-lactational breast. JR Coll Surg Edin. 1995;40:25-27.
Gajiwala KJ. Puncture, drainage and irrigation: Is that enough for treating an abscess? Indian J Plastic Surg. 2006;39(2):189-95.
Abraham N, Doudle M, Carson P. Open versus closed surgical treatment of abscesses: A controlled clinical trial. Aust N Z J Surg. 1997;67:173-6.
Ellis M. Incision and Primary suture of Abscesses of the Anal region. Proc R Soc Med. 1960;53:652-3.
Mehta PH, Dunn KA, Bradfield JF, Austin. Contaminated wounds infection in subcutaneous sutures. Ann Emer Med. 1996;27:43-8.
Simms MH, Curran F, Johnson RA, Oates J, Givel JC, Chalbloz R, et al. Treatment of acute abscesses in casualty department. Br Med J. 1982;284:1827-9.
Rosner P, Julius Preuss - biblical and Talmudic medicine, New York; 1978:1194-1198.
Singer AJ, Taira BR, Chale S, Bhat R, Kennedy D, Schmitz G. Primary Versus Secondary Closure of Cutaneous Abscesses in the Emergency Department: Randomized Controlled Trial. Acad Emerg Med. 2013;20(1):27-32.
Edino ST, Ihezue CH, Obekpa. Outcomes of primary closure in subcutaneous abscesses. Niger Post Med J. 2001;8:32-6.
Visvanathan R. Primary Closure Following Drainage of the Rectus Sheath Muscle. Singapore Med J. 1994;35:108-9.
Dubey V, Choudhary SK. Incision and drainage versus incision and drainage with primary closure and use of closed suction drain in acute abscesses. Wounds. 2013;25:58-60.
Khanna YK, Khanna AA, Singh SP, Laddha BL, Prasad PP, Jhanji RN. Primary closure of gluteal injection abscess (a study of 100 cases). J Post Med. 1984;30(2):105-10.