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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Minimally invasive technique in treatment of complex, subcutaneous abscesses in children
Alan P Ladd1, Marc S Levy, Jennifer Quilty
1Division of Pediatric Surgery, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN 46202, USA. aladd@iupui.edu
Insights
A new minimally invasive technique successfully treated complex pediatric subcutaneous abscesses, including those caused by MRSA, with no recurrence or complications. This method offers effective drainage and simplified wound care for children.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Dermatology
Background:
- Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) is increasingly prevalent.
- This has led to a rise in complex subcutaneous abscesses in children.
- Effective treatment strategies for these pediatric abscesses are crucial.
Purpose of the Study:
- To present a novel minimally invasive technique for draining complex pediatric subcutaneous abscesses.
- To report early outcomes of this new drainage method.
Main Methods:
- Retrospective review of 128 pediatric patients treated between July 2006 and August 2007.
- Utilized a technique involving peripheral stab incisions for drainage, debridement, irrigation, and vessel-loop drain placement.
- Managed with topical wound care twice daily, with drain removal upon resolution of cellulitis and drainage.
Main Results:
- MRSA was identified in 76% of cultured specimens.
- Average length of hospital stay was 1.5 days; 30 patients were treated as outpatients.
- No local recurrences or procedure-related morbidity were observed. Average drain use was 9 days.
Conclusions:
- A successful, minimally invasive technique for complex pediatric abscess drainage has been established.
- This method requires limited postoperative wound care.
- The technique demonstrated no morbidity or recurrence in the study cohort.
Unlabelled:
The rising prevalence of community-acquired, methicillin-resistant Staphylococcus aureus (MRSA) has correlated with an escalating number of complex, subcutaneous abscesses in pediatric patients. The purpose of this study was to present a novel technique and early outcome results for the minimally invasive drainage of complex, subcutaneous abscesses.
Methods:
Patients' outcomes from the treatment of complex, subcutaneous abscesses were retrospectively reviewed under institutional review board approval from July 2006 to August 2007 at 2 independent, tertiary care pediatric hospitals. Data on patients' demographics, length of hospital stay, and length of treatment were collected, along with analysis of the isolated organisms. The operative technique uses drainage of the abscess through peripheral stab incisions. Cavity debridement and irrigation is followed by placement of a vessel-loop drain through the drainage incisions. Topical wound care without packing is performed twice a day. Drain removal follows resolution of cellulitis and drainage.
Results:
One hundred twenty-eight patients were treated over a 14-month period. The ratio of females to males was 1.25:1. Average patient age was 51.5 months (median, 21 months) and ranged from 5 weeks to 18 years. The average length of hospital stay was 1.5 days, though 30 patients were treated on an outpatient basis. Methicillin-resistant Staphylococcus aureus was identified in 76% of the cultured specimens. Average length of drain use was 9 days (range, 5-29 days). There were no local recurrences of subcutaneous abscesses. There was no morbidity related to the drainage procedures.
Conclusion:
We present a successful technique for the drainage and treatment of complex abscesses in children with limited, postoperative wound care and no morbidity or recurrence.
