loop abscess

Looking for a fun and interesting new way to treat an abscess?

(I've done it once, with good success.)

You tube video - only 2 minutes long, worth watching, and worth reviewing in the ED before actually trying this:

Dr. Tsoriades and colleagues found using a vessel loop (see picture) was a safe and effective treatment for subcutaneous abscesses in children when studied in comparison with traditional incision and drainage with packing. 

Children in the study were under general anesthesia or conscious sedation. (I used a traditional field block using 2% lidocaine with epinephrine in an adult.)

Pros:

• no repeat packing
• better tolerated by patients
• less wound care materials
• much smaller incision - less scarring

Discharge instructions:

• apply warm compresses
• expect drainage
• move loop back and forth 2 times daily 
• return if worse/fever/increasing redness

Submitted by S. Morris.

Reference(s): A.P. Ladd, M.S. Levy, J. Quilty. Minimally invasive technique in treatment of complex, subcutaneous abscesses in children. J Pediatr Surg, 45 (2010), pp. 1562–1566;  S.S. Tsoraides, R.H. Pearl, A.B. Stanfill, L.J. Wallace, R.K. VeguntaIncision and loop drainage: A minimally invasive technique for subcutaneous abscess management in children J Pediatr Surg, 45 (2010), pp. 606–609; picture