LOOP DRAINAGE VERSUS CONVENTIONAL INCISION AND DRAINAGE TECHNIQUE IN CUTANEOUS ABSCESSES – A RANDOMIZED CONTROLLED TRIAL
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Keywords
Loop Drainage, Cutaneous, Abscess, Conventional, Incision, Adult, population
Abstract
Background: Cutaneous abscesses are increasingly frequent in adult and paediatric surgical emergency rooms. The treatment methods include conventional incision and drainage and secondary closure, primary closure with antimicrobial coverage, and loop incision, drainage.
Objective: To compare the short term outcomes after Loop Drainage of Cutaneous abscess versus conventional Incision and Drainage technique in the adult population.
Study design: Randomized controlled trial (no blinding).
Place and duration of study: Department of Surgery, Services Hospital, Lahore, Pakistan from 30th November 2019 to 30th May 2020.
Methodology: Study was conducted on 256 participants. Participants were randomized in two groups in 1:1 ratio using lottery method. Group A included Conventional Incision and Drainage Technique which is Simple incision made at the most fluctuant part of the swelling. Group B was Loop Drainage Technique in which two small incisions were made at abscess edges, 3-5cm apart. Outcome variables including operative time, pain score, change in abscess diameter were recorded on proforma.
Results: Patients in group A had a mean age of 42.61±13.34 years, whereas those in group B had 41.80±14.79 years. Compared to group B, group A included 56 men (43.8%) and 72 females (56.3%). The mean operating time in group A was 16.49±1.12 min while in group B the mean operating time was 14.99±3.41 min (p<0.05). The mean pain score in group A was 4.28±1.79, whereas in group B the mean pain score was 6.00±1.47 (p-value=0.000). The mean diameter in abscess before drainage in group A was 3.35±1.04 while in group B the mean diameter of abscess before drainage was 3.51±1.17. The mean diameter in abscess after drainage in group A was 2.66±1.04 whereas in group B the mean diameter of abscess after drainage was 2.77±1.16. The change in diameter in abscess in group A was 0.68±0.10. On the other side in group B the mean change in diameter of abscess was 0.60±0.11 (p-value=0.000)
Conclusion: The loop drainage technique was found to have better outcome as compared to conventional incision and Drainage Technique. So, it is concluded that Loop Drainage Technique for Cutaneous abscess is a safe and effective technique in the adult population.
References
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Muhammad Kamil Zulfiquar
Post Graduate Trainee in General Surgery, Services Hospital, Lahore Pakistan
Muhammad Adil Zulfiquar
Post Graduate Trainee in General Surgery, Services Hospital, Lahore Pakistan
Usama Rafi
Post Graduate Trainee in General Surgery, Services Hospital, Lahore Pakistan
Muhammad Saim Azam
Post Graduate Trainee in General Surgery, Services Hospital, Lahore Pakistan
Affaf Ahmed
Post Graduate Trainee in General Surgery, Allied Hospital, Faisalabad Pakistan
Iqra Khalid
Post Graduate Trainee in Paediatric Surgery, Allied Hospital, Faisalabad Pakistan
Fajar Noor
Mayo Hospital, Anarkali, Lahore Pakistan
Hareem Nazeef
Central Park Teaching Hospital, Lahore Pakistan