A Comparison of Techniques for Treating Skin Abscesses

Management of abscesses traditionally involves incision and drainage (I&D). Abscesses are
frequently are "packed" or stented open with the presence of a wick, and traditional care
requires re-visits every 2-3 days to have the packing removed and replaced, until finally the
abscess cavity has closed, usually 1-2 weeks after initial presentation.

Recently there have been attempts to employ less invasive techniques for abscess management.
One novel technique, "loop drainage", has been reported in case reports/case series for
management of a variety of types of abscesses in the surgical subspecialty literature.

We propose to conduct a randomized prospective study comparing the efficacy of the loop
drainage technique with the traditional incision and drainage technique of abscess
management.

Patients presenting to the main or urgent care areas of the Emergency Department at Boston
Medical Center for treatment of an abscess will be considered for enrollment as potential
subjects. After the treating clinician identifies the patient as an appropriate subject, a
Research Associate (RA) will approach the patient and obtain written informed consent to
enroll in the study. The subject will then be randomized to the management arm of either loop
drainage or traditional I&D. The clinician will fill out a data sheet describing the abscess
characteristics, and then perform either loop drainage or incision and drainage, depending on
randomization and the subject will fill out a satisfaction survey. Fourteen days after
initial visit, subjects will return for follow-up. The subject will fill out a satisfaction
survey, and a study investigator blinded to the treatment group will assess the subject for
abscess resolution, cosmetic outcome, number of follow-up visits, and complications.

The study investigators will then compare outcomes between the two study groups.