Loop Abscess Drainage Technique
The better way to drain...
|National Medical Library of Science Data||All ED Visits|
|Year||Overall Rank||Diagnoses (CCS name)||Number of Visits||% of Visits||% Admited||% Died||Mean Age|
|2011||7||Skin and subcutaneous tissue infections||3,354,191||2.6||14.4||0.30||37|
|2012||7||Skin and subcutaneous tissue infections||3,430,734||2.6||14.2||0.30||37|
|2013||7||Skin and subcutaneous tissue infections||3,404,714||2.5||14.1||0.30||38|
|Data Use Agreement for HCUPnet, Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services|
Standard incision and drainage procedure
Vessel Loop technique was initially tested in emergency departments, then embraced by the pediatric surgeons.
Conclusion: This is the first loop and drain technique (LDT) data in adults and proves it is safe and effective. It saves operating theatre time with 30% of LDT treated in the Emergency Department and ensures excellent follow-up compliance as patients return for VessiLoop removal. Healthcare burden is greatly reduced using LDT; most patients require only one review (physician visit) at 10–14 days.
Discussion: ...with the evidence presented in this study, we would advocate LDT for complex subcutaneous abscesses ranging from the well patient with small size abscess through to the setting of a larger abscess sized, high-anaesthetic risk patient with comorbidities on the provisor that systemic inflammatory response, sepsis or spreading soft tissue infection, such as necrotizing fasciitis, have been excluded... We recommend the use of LDT for the Australian adult population, including in an outpatient setting.
|Year||Author||Setting/Abcsess Type||Study Type||(N)||Outcome||Conclusion|
|2017||Starr Seal RL et al||PED/ all types||Retrospective/ Cross-Sectional||224 pre-loop, 194 post-loop||Loop use increased to 56% after 3yr implementation time. 24% return visits in pre-loop, 9.3% in post loop period. Less returns with loop in general.||**Comparing time periods not technique** No increase in complication/ treatment failures. Return visits significantly decreased.|
|2016||Gaszynski R et al||OR/ Adult all types||Retrospective||63 (36 loop, 27 standard)||Reoperation rate 0%||Loop technique is recommended as standard of care.|
|2016||Aprahamian CJ et al||Pediatrics all types||Retrospective||576||Reoperation rate 4.5% (26, 2 who were planned, 1 accidental removal).||Loop technique is recommended as standard of care.|
|2015||Ladde JG||ED/ Pediatrics all types||Retrospective||233 (79 loop, 154 standard)||Failure rate 1.4% loop vs 10.5% Standard I&D.||Loop technique may be better, need prospective study.|
|2013||Wright TN et al||OR/ Pediatrics mainly complex||Retrospective, hospital outcomes assessment||329 (127 loop, 202 standard)||Loop with need for repacking and LOS of 2 days vs 1 day.||Loop associated with $520 reduction in median direct costs and $385 reduction in median indirect costs.|
|2011||McNamara WF et al||OR/ Pediatrics all types||Retrospective||219 (85 loop, 134 standard)||Location, antibiotics, bacteriology, fever comprable. I$D 4 recurrences, 1 additional procedure. Drain with no recurrences or additional procedures.||Equally effective, loop had better cosmetic appearance in immediate post-op.|
|2011||Alder AC et al||OR/ Pediatrics all types||Prospective||400 (78 loop, 322 standard)||Loop - no failures. Standard 10.6% needed repacking and longer LOS.||Catheter drainage is effective and associated with decresed LOS.|
|2010||Ladd AP et al||OR/ Pediatrics all complex||Retrospective case series, 2 hospitals||128 loops||0 failures||Hospital LOS 1.5 days, 30 treated as outpatient. Home self irrigation.|
|2010||Tsoraides et al||OR/ Pediatrics mainly complex||Retrospective case series||115 loops||5.5% Failure rate||Simplified post-op care and decreased cost of home care.|
|2008||Ladde JG et al||ED/ Pediatrics all types||Retrospective||233 (79 loop, 154 standard)||Overall failure 12%, 3.8% in LOOP, 16.5% in Standard||Significant difference in failure rate. Novel technique shows promise as an alternative to I&D with packing|
|2005||Ginnis et al||ED/ Adults Bartholin cysts||Prospective||38 (25 Ring, 13 Word catheter)||No recurrences at 6 months. Similar ease of insertion. Patient satisfaction higher in patients with the ring catheter.||No difference in outcomes, but higher patient satisfaction.|