International Journal of Surgery and Surgical Sciences (IJSSS)
Acute Pyogenic Abscess: Comparison of Primary Closure Method with Conventional Incision and Drainage
Abstract
Introduction: Acute pyogenic abscess is a common soft tissue infection requiring surgical intervention. Incision and drainage are conventional method requiring repeated dressings and healing with secondary intention. Primary closure method reduces number of dressings and aims to attain wound healing by primary intention. Present study aims to compare both these techniques.
Methods: In a hospital based non-randomized comparative study, patients of soft tissue infection diagnosed clinically as pyogenic abscess or by imaging in deep seated abscess of size ≥ 5 cms were included as cases. Patients with co-morbid condition or abscesses located in perineum, scrotum and head, neck and face were excluded. Patients were assigned to intervention on surgical decision across multiple surgical units. One group was treated with conventional incision and drainage while other group was treated by primary closure with suction drain method. Outcomes were recorded as, Post-operative pain and on demand analgesia, number of dressings required, and duration of healing in days. Baseline features of both groups and outcomes were compared using student’s t test for continuous variable and chi square test for categorical variable.
Results: Total 68 patients with mean age of 36.97±11.87 years and male: female ratio of 1: 0.88 were enrolled. Breast abscess accounted for 42.6% cases, thigh abscess 32.5% and rest 25% were at other sites. The post-operative mean VAS score on day 1 was 6.44±0.613 in primary closure group as compared to 8.12±0.640 in conventional incision and drainage (p<0.001). Mean number of on demand analgesia and dressings changes in primary closure group was statistically significantly less than conventional incision and drainage (p<0.001). Mean healing duration in primary closure was 14.32±2.507 days and in conventional incision and drainage 20.21±6.347 days (p<0.001).
Conclusion: Primary closure technique is superior to the conventional incision and drainage technique in terms of duration of healing, post-operative pain, number of on demand analgesia, number of dressings required, with the same complication rate.
Keywords
References
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