The loop technique involves making two incisions at either pole of a skin abscess to initially drain its purulent contents. A loop drain is then inserted into one incision site and out the other, tied off above the skin with some movement of the loop drain allowed. The drain can be cut at follow-up in 7-10 days.
[1]
A retrospective study of 233 abscesses in a pediatric ED compared the LOOP technique versus standard I&D with packing, and showed a significantly reduced failure rate in the LOOP group (1.4% vs 10.5%, p<.03). However, the LOOP group had a significant difference in patient age (4.4 vs 7.1 yrs in standard group, p<0.001) and less follow-up to assess clinical outcome (36% vs 64% in standard group). [2]
If a loop drain is not readily available in your emergency department, the rubber ring at the cuff of a sterile glove can be cut off and used as an alternative drain. [3]
[4]
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Sources:
- Wednling P. Novel technique improved skin abscess drainage. ACEP News. 2009 Jan. Available at http://www.acep.org/Clinical—Practice-Management/Novel-Technique-Improved-Skin-Abscess-Drainage/?__taxonomyid=118007
- Ladde JG, Baker S, Rodgers CN, Papa L. The LOOP technique: a novel incision and drainage technique in the treatment of skin abscesses in a pediatric ED. Am J Emerg Med. 2015 Feb;33(2):271-6.
- Thompson DO. Loop drainage of cutaneous abscesses using a modified sterile glove: a promising technique. J Emerg Med. 2014 Aug; 47(2): 188-91.
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