Daily Em Pearl, 4/22/12

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    Daily Em Pearl, 4/22/12

    Abscess: After incision and drainage, do you pack or not? What does the literature say?

    The jury is still out but is leaning toward don’t pack. Healing times and complication rates may be about the same but perhaps people have less pain sans packing.

    Unfortunately most of the literature is over twenty years old and most of it is actually about primary closure (I&D and then suture closed) versus simply drainage (+/- packing).

    Recent study: O’Malley GF. Routine packing of simple cutaneous abscesses is painful and probably unncessary. Acad Emerg Med. 2009, 16 (5): 470-473. This is a small (48 pts) prospective, randomised, single-blinded study with limited generalizability (look at their study population).

    Ref:

    Milne K. Abscesses: To pack or not to pack? Emergency Physicians  Monthly. May 2010 Vol 17, No. 5, p: 10,31. (note some of the listed references in this article are incorrectly described; you should review them on your own)

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