Abscesses are already painful and can cause scars, so why don’t we try a cool move to minimize this for patients?  Loop drainage has come to the forefront due to lower failure rates, less scaring, continuous draining, and no need for packing/repacking!

How is it done?  (https://www.youtube.com/watch?v=hkEidzzs0JY)
1. Numb the abscess with lidocaine +/- epi (keeping in mind the toxic dose of ~4.5 mg/kg )
2. Make two small incisions on opposite sides of the abscess
3. Place Kelly clamps through the holes and break up the loculations

4. Run a loop through both holes and tie it in a knot.  Don’t tie the knot tight, just needs to to stay together.

Don’t have a silicone vascular loop?  You can also use Penrose drain or finger of a glove.  

Does it really work?  Yeah, https://www.ncbi.nlm.nih.gov/pubmed/28917436.  This technique shows lower failure rates, especially in children.

A reliable patient can even take it out themselves.  And an unreliable patient now has a reason to return to the ED for wound check.  If you’re doing one of these in the next month, keep your TR in the loop!