Dr. Elyse Watkins
Purpose: The purpose of this article is to review all methods that are argued when it comes to managing a subcutaneous abscess in the emergency department. The article will review the benefits of using ultrasound prior to incision and drainage, the argument of packing versus not packing an abscess, and lastly whether or not the provider should prescribe antibiotics after a successful incision and drainage.
Method: Database used to search was PubMed and the terms used to guide the strategy include, Subcutaneous abscess AND packing, Not packing an abscess, and Outcome of not packing abscess. The filters used were random clinical trial, clinical trial, review, last 10 years and humans. A second search was done to determine the use of point of care ultrasound (POCUS) prior to an incision and drainage of an abscess. The strategy used was searching abscess AND ultrasound. Filters used for the POCUS on abscess were random clinical trial, clinical trial, review, last ten years and humans. The final search on PubMed was to determine the use of antibiotics in conjunction with an incision and drainage. The strategy used was skin abscess and antibiotics. Similar filters were used again for antibiotics for skin abscess, using a random clinical trial, clinical trial, review, last 10 years and again humans.
Results: Multiple results were found for all three searches. The results for packing an abscess revealed that packing made no difference in the outcome of patients. The search also revealed that antibiotics in conjunction with incision and drainage was favorable over not having antibiotics. Lastly, POCUS was very helpful to clinicians in determining location and size of an abscess and assisted in distinguishing an abscess from cellulitis.
Memon AS. Complete Guide to Managing a Subcutaneous Abscess in the Emergency Department. Lynchburg Journal of Medical Science. 2020; 2(1).
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