Carbuncle management: skin-sparing saucerization followed by delayed primary closure is a new treatment modality: a...

Carbuncles are deep infections of the subcutaneous tissue not originating from skin, and often require surgical intervention. The traditional approach, which includes aggressive debridement via saucerization and prolonged antibiotic therapy, presents several limitations, such as delayed wound healing, extended hospital stays, increased dressing requirements, and heightened risks of antibiotic resistance. This case series evaluates a new skin-sparing saucerization technique followed by delayed primary closure, which has demonstrated improved outcomes in wound healing and overall patient recovery.

A case series of ten patients who underwent skin-sparing saucerization is presented. The patients, aged 44-62 years and of Chinese and Malay ethnicity, had wound sizes ranging from 4 to 8 cm, located on various anatomical regions, including the back, anterior abdomen, axilla, and gluteal area. Some patients had underlying conditions such as diabetes mellitus, hypertension, and hypercholesterolemia, which could complicate wound healing. Unlike the conventional approach, which leaves wounds open to heal by secondary intention, this technique preserves surrounding healthy skin by delaying primary closure, allowing for better granulation and minimizing the risk of infection. Postoperative outcomes showed significant improvement in healing time, with wound closure achieved within 2-5 weeks compared with the prolonged healing durations commonly associated with conventional techniques. Hospital stays were notably shortened to 1-3 days, enabling earlier discharge and reducing the burden of prolonged inpatient care. Most patients experienced uneventful recovery, with only one case of mild surgical site infection and one patient requiring additional wound monitoring due to delayed granulation.

The skin-sparing saucerization technique followed by delayed primary closure offers a promising alternative to conventional methods, particularly for patients with underlying health conditions. This approach reduces hospital stays, enhances wound healing, minimizes dressing changes, and allows for an earlier return to daily activities, ultimately improving patient quality of life. Further studies with larger sample sizes are necessary to establish standardized protocols and confirm the broader efficacy of this method.