Loop drainage of Abscess

1. Rashid Abuelhassan, MBBS, MRCEM
INCISION AND LOOP
DRAINAGE IN TREATMENT
OF ABSCESS

2. • Abscess :collection of pus , a thick,
yellowish fluid caused by bacteria,
protozoa, or fungal
• Common site in pediatric
• gluteal
• perianal area
• abscess involved hair follicles and neck
and axilla

3. Pathophysiology
An abscess is
a defensive
reaction
organisms or
foreign
materials kill
the local cells,
release of
cytokines.
trigger an
inflammatory
response
draws white
blood cells +
↑regional
blood flow.
abscess
capsule

4. Management ?

5. Treatment
I&D
What is the best method ?

6. • Disadvantages:
• painful
• anxiety for removal of
backing with dressing
• coast effectiveness .

7. with packing or without
packing ?

8. Incision and loop drainage: a minimally invasive technique for subcutaneous
abscess management in children
METHODS:
A retrospective study was performed of all children who underwent incision and
loop drainage for subcutaneous abscesses between January 2002 and October
2007 at our institution
CONCLUSION:
The use of loop drains proved safe and effective in the treatment of subcutaneous
abscesses in children. Eliminating the need for repetitive and cumbersome wound
packing simplifies postoperative wound care. Furthermore, there is an expected
cost savings with this technique given the decreased need for wound care
materials and professional postoperative home health services. We recommend
this minimally invasive technique as the treatment of choice for subcutaneous
abscesses in children and consider it the standard of care in our facility

9. Treatment of subcutaneous abscesses in children with
incision and loop drainage: A simplified method of care
Charles J Aprahamian, Hilana H Nashad, Nerina M
DiSomma, Breanna M Elger, Joseph R Esparaz, Thomas J
McMorrow, Alexandria M Shadid, Angela M Kao, Mark J
Holterman, Robert C Kanard, Richard H Pearl
Journal of Pediatric Surgery 2017, 52 (9): 1438-1441

10. Why I&LD
• Better tolerated by patient
• More patient involvement with self care.
• Better cosmoses.
• More coast effective .

11. What is I&LD
1. Incision of abscess and after
breaking loculation and
effective irrigation with saline
2. do another opening and put
sterile rapper like or silicon
with free edge not tied with
tension to skin make it free to
use by patient during shower
and dressing and to be
removed after 7days .

13. HOME MESSAGE
• Minimizes scarring (two small incisions instead of one large one).
[Aprahamian, 2016]
• Eliminates the need for repeat visits for wound packing changes.
[Aprahamian, 2016]
• This saves the patient / family the time of returning multiple times.
• Also saves the patient the pain and anxiety of having the packing changed.
• Also saves ED visit cost.
• In theory, the loop could be removed by any provider (PCP, Urgent Care, etc).

14. Refrences