A Comparative Study Between Standard I & D And Novel Technique Incision & Loop Drainage (I & LD)

Indian Journal of Applied Basic Medical Sciences
Year: 2019, Volume: 21(B), Issue. (2)
First page: (102) Last page: (108)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi:

A Comparative Study Between Standard I & D And Novel  Technique Incision & Loop Drainage (I & LD)  
Urvish R Parikh1, Divyang Sadhwani2*, Shivendra Agrawal2, Pooja Gwalani2,  Sudhir B Chandana3
1Assistant Professor Pediatric Surgery, 22nd year Resident-General Surgery, 3Professor & Head- Pediatric  Surgery Department of Pediatric Surgery, Smt. NHL Municipal Medical College & VS General Hospital,  Ellisbridge, Ahmedabad – 380006 (Gujarat) 
 Correspondence author email id: divyang.sadhwani@gmail.com

Online Published on 02-Jul-2019

ABSTRACT

PURPOSE: The aim of the study was to evaluate the outcome after a minimally invasive approach to pediatric subcutaneous abscess management as an alternative to wide exposure, debridement and repetitive pack dressing. METHODS: A Retrospective study was performed of 280 children who underwent standard I & D and I & LD for subcutaneous abscesses between JAN-2011 to MAY-2017 in our institute. TECHNIQUE: In I & LD, two (sometimes three) mini incisions 4-5 mm each were made on the abscess as far apart as possible, cavity probed and septa broken with hemostat forceps and pus drained. A swab for pus culture and sensitivity was taken. Cavity irrigation was done with betadine & hydrogen peroxide. A thin slit of corrugated drain, penrose drain or surgical glove-finger was used as a loop and tied to itself such that there was no tension on the skin. Postoperatively empirical antibiotics were started & altered SOS based on pus CS report. Daily close dressing was done for 3-4 days and then open dressing depending upon discharge coming from incisions. Most patients were discharged on 3rd to 7th day and drain was removed around 8th day. RESULTS: The technique was applied to all sites of subcutaneous abscesses. Some cases of I & LD were converted to traditional I and D based on clinical observation of dressings, bringing the failure rate of I & LD to 4% in our study. But the technique provided numerous advantages over the traditional I & D. CONCLUSION: The use of loop drainage proved safe, effective and better in the treatment and management of subcutaneous abscesses in children in our study.

Keywords

penrose, hemostat forceps, debridement, Loop Drainage

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