Review Article

Purulent Skin and Soft Tissue Infections, Challenging the Practice of Incision and Drainage: A Scoping Review

Table 2

Final exclusions.

Author and yearStudy titleWeb link/doiCommentsFocus of the studyTest intervention reported efficiency in SSTI resolution

Winstead, 2012 [71]Evaluating and Managing Uncomplicated Skin and Soft Tissue Infections Associated with Community-Associated Methicillin-Resistant Staphylococcus aureus for Outpatients: A Review of the Literaturehttps://doi.org/10.1891/1939-2095.5.2.98For final inclusionTraditional I&DNot Documented

Llera et al., 1984 [68]Cutaneous Abscesses: Natural History and Management in an Outpatient Facilityhttps://doi.org/10.1016/0736-4679(84)90002-7For final inclusionTraditional I&D73%

Singer and Talan, 2014 [72]Management of Skin Abscesses in the Era of Methicillin-Resistant Staphylococcus aureushttps://doi.org/10.1056/NEJMra1212788For final inclusionTraditional I&D80%

Alder et al.,, 2011 [64]A comparison of Traditional Incision and Drainage versus Catheter Drainage of Soft Tissue Abscesses in Childrenhttps://doi.org/10.1016/j.jpedsurg.2011.05.025For final inclusionCatheter drainage75%

Mahida et al. 2015 [74]Using Quality Improvement Methods to Change Surgical Practice: A Case Example of Pediatric Soft Tissue Abscesseshttps://doi.org/10.1097/QMH.0000000000000054For final inclusionCatheter drainage75%

Yang et al., 2017 [33]A High-Vacuum Wound Drainage System Reduces Pain and Length of Treatment for Pediatric Soft Tissue Abscesseshttps://doi.org/10.1007/s00431-016-2835-2For final inclusionSuction drainage96%

Zihmin et al. 2020 [77]Therapeutic effect of Topical Negative Pressure Therapy/Vacuum-Associated Closure Therapy on Cephalic Facial Skin Abscesshttps://doi.org/10.1089/sur.2019.184For final inclusionSuction drainage10–12 days

Tsoraides et al., 2010 [70]Incision and Loop Drainage: A Minimally Invasive Technique for Subcutaneouse Abscess Management in Childrenhttps://doi.org/10.1016/j.jpedsurg.2009.06.013For final inclusionLoop drainage94.50%

Schechter-Perkins, 2020 [21]Loop Drainage Is Noninferior to Traditional Incision and Drainage of Cutaneous Abscesses in the Emergency Departmenthttps://doi.org/10.1111/acem.13981For final inclusionLoop drainage88%

Ozturan et al., 2009 [75]Comparison of Loop and Primary Incision and Drainage Techniques in the Emergency Departmenthttps://doi.org/10.1016/j.ajem.2017.01.036For final inclusionLoop drainage87%

McNamara et al., 2011 [65]An Alternative to Open Incision and Drainage for Community-Acquired Soft Tissue Abscesses in Childrenhttps://doi.org/10.1016/j.jpedsurg.2010.08.019For final inclusionLoop drainage100%

Gottlieb et al., 2021 [57]Comparison of the Loop Technique with Incision and Drainage for Skin and Soft Tissue Abscesses: A Systematic Review and Meta-Analysishttps://doi.org/10.1111/acem.14151For final inclusionLoop drainage91.73%

Ladde et al., 2015 [73]The Loop Technique: A Novel Incision and Drainage Technique in the Treatment of Skin Abscesses in a Pediatric EDhttps://doi.org/10.1016/j.ajem.2014.10.014For final inclusionLoop drainage98.60%

Long and Apiril, 2019 [76]Is Loop Drainage Technique More Effective for Treatment of Soft Tissue Abscess Compared with Conventional Incision and Drainage?https://doi.org/10.1016/j.annemergmed.2018.02.006For final inclusionLoop drainage95.9%

Rencher et al., 2016 [66]Comparison of Loop Drainage versus Incision and Drainage for Abscesses in Childrenhttps://doi.org/10.1097/PEC.0000000000001732For final inclusionLoop drainage92.7%

Eryilmaz et al., 2005 [69]Management of Lactational Breast Abscesseshttps://doi.org/10.1016/j.breast.2004.12.001For final inclusionNeedle aspiration41%

Gaspari et al., 2011 [19]A Randomised Controlled Trial of Incision and Drainage versus Ultrasonographically Guided Needle Aspiration for Skin Abscesses and the Effect of Methicillin-Resistant Staphylococcus aureushttps://doi.org/10.1016/j.annemergmed.2010.11.021For final inclusionNeedle aspiration26%

Lasithiotakis et al., 2018 [32]Aspiration for Acute Pilonidal Abscess: A Cohort Studyhttps://doi.org/10.1016/j.jss.2017.09.051For final inclusionNeedle aspiration83%

Singer et al., 2011 [67]Primary Closure of Cutaneous Abscesses: A Systematic Reviewhttps://doi.org/10.1016/j.ajem.2009.10.004For final inclusionI&D with primary closure92.4%

Kotlářová et al., 2021 [42]Antibiotic Therapy in the Treatment of Skin Abscess Meta-Analysishttps://doi.org/10.33699/PIS.2021.100.7.325-329Excluded: the effects of antibiotics following traditional I&DN/A

Talan, 2016 [15]Trimethoprim-Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscesshttps://doi.org/10.1056/NEJMoa1507476Excluded: the effects of antibiotics following traditional I&DN/A

Daum et al., 2017 [14]A Placebo-Controlled Trial of Antibiotics for Smaller Skin Abscesseshttps://doi.org/10.1056/NEJMoa1607033Excluded: the effects of antibiotics following traditional I&DN/A

Duong et al., 2010 [37]Randomised, Controlled Trial of Antibiotics in the Management of Community-Acquired Skin Abscesses in the Pediatric Patienthttps://doi.org/10.1016/j.annemergmed.2009.03.014Excluded: the effects of antibiotics following traditional I&DN/A

Cenizal et al., 2007 [35]Trimethoprim-Sulfamethoxazole or Doxycycline for Skin and Soft Tissue Infectionshttps://doi.org/10.1128/aac.00206-07Excluded: the effects of antibiotics following traditional I&DN/A

Daum et al. 2016 [36]Clindamycin versus Trimethoprim-Sulfamethoxazole versus Placebo for Uncomplicated Skin and Soft Tissue Abscesseshttps://doi.org/10.1093/ofid/ofw194.111Excluded: the effects of antibiotics following traditional I&DN/A

Elliott et al., 2009 [38]Empiric Antimicrobial Therapy for Pediatric Skin and Soft Tissue Infections in the Era of Methicillin-Resistant Staphylococcus aureushttps://doi.org/10.1542/peds.2008-2428Excluded: the effects of antibiotics following traditional I&DN/A

Gottlieb, 2017 [40]Comparison of Trimethoprim-Sulfamethoxazole Versus Placebo for Uncomplicated Skin Abscesseshttps://doi.org/10.1017/cem.2016.367Excluded: the effects of antibiotics following traditional I&DN/A

Lee et al., 2004 [43]Management and Outcome of Children with Skin and Soft Tissue Abscesses Caused by Community-Acquired Methicillin-Resistant Staphylococcus aureushttps://doi.org/10.1097/01.inf.0000109288.06912.21Excluded: the effects of antibiotics following traditional I&DN/A

López et al., 2018 [44]Comparative Study of Drainage and Antibiotics versus Drainage Only in the Management of Primary Subcutaneous Abscesseshttps://doi.org/10.1089/sur.2017.225Excluded: the effects of antibiotics following traditional I&DN/A

Powers, 1991 [46]Soft Tissue Infections in the Emergency Department: The Case for the Use of 'Simple' Antibioticshttps://doi.org/10.1097/00007611-199111000-00005Excluded: the effects of antibiotics following traditional I&DN/A

Talan,, 2018 [47]Subgroup Analysis of Antibiotic Treatment for Skin Abscesseshttps://doi.org/10.1016/j.annemergmed.2017.07.483Excluded: the effects of antibiotics following traditional I&DN/A

Vermandere et al., 2018 [48]Antibiotics after Incision and Drainage for Uncomplicated Skin Abscesses: A Clinical Practice Guidelinehttps://doi.org/10.1136/bmj.k243Excluded: the effects of antibiotics following traditional I&DN/A

Fahimi et al., 2015 [39]The Role of Adjunctive Antibiotics in the Treatment of Skin and Soft Tissue Abscesses: A Systematic Review and Meta-Analysishttps://doi.org/10.1017/cem.2014.52Excluded: the effects of antibiotics following traditional I&DN/A

Gottlieb, 2019 [41]Systemic Antibiotics for the Treatment of Skin and Soft Tissue Abscesses: A Systematic Review and Meta-Analysishttps://doi.org/10.1016/j.annemergmed.2018.02.011Excluded: the effects of antibiotics following traditional I&DN/A

Mistry et al., 2014 [45]Clinical Management of Skin and Soft Tissue Infections in the U.S. Emergency Departmentshttps://doi.org/10.5811/westjem.2014.4.20583Excluded: the effects of antibiotics following traditional I&DN/A

Schmitz et al., 2010 [20]Randomised Controlled Trial of Trimethoprim-Sulfamethoxazole for Uncomplicated Skin Abscesses in Patients at Risk for Community-Associated Methicillin-Resistant Staphylococcus aureus Infectionhttps://doi.org/10.1016/j.annemergmed.2010.03.002Excluded: the effects of antibiotics following traditional I&DN/A

UknownOutcomes of a Novel Technique of Mini- Incision and Self-Express (Mise) for Breast Abscesshttps://beta.clinicaltrials.gov/study/NCT05762016Excluded: this is a protocolN/A

Gulack, 2023 [54]Conservative Management of Cutaneous Abscesshttps://beta.clinicaltrials.gov/study/NCT05461053Excluded: this is a protocolN/A

Miller, 2023 [53]Short- and Long-Term Outcomes of Doxycycline versus Trimethoprim-Sulfamethoxazole for Skin and Soft Tissue Infections Treatmenthttps://clinicaltrials.gov/show/NCT03637400Excluded: this is a protocolN/A

Koehler and Nakayama, 2009 [49]Treatment of Cutaneous Abscesses without Postoperative Dressing Changeshttps://doi.org/10.1016/j.aorn.2009.04.026Excluded: I&D with or without packingN/A

Washington University School of Medicine [80]Abscess Packing versus Wick Placement after Incision and Drainagehttps://clinicaltrials.gov/show/NCT01281930Excluded: I&D with or without packingN/A

O'Malley et al., 2009 [50]Routine Packing of Simple Cutaneous Abscesses is Painful and Probably Unnecessaryhttps://doi.org/10.1111/j.1553-2712.2009.00409.xExcluded: I&D with/without packingN/A

Oehme et al., 2020 [3]Simple Wound Irrigation in the Postoperative Treatment for Surgically Drained Spontaneous Soft Tissue Abscesses: A Prospective, Randomised Controlled Trialhttps://doi.org/10.1007/s00268-020-05738-1Excluded: wound irrigation not interventionN/A

Rühle, 2021 [55]International Survey Evaluating Treatment of Primary Superficial Skin Abscesseshttps://doi.org/10.1007/s00068-019-01279-yExcluded: no study of intervention and survey of surgeonsN/A

Brody et al. 2019 [59]A Novel Silicon Device for the Packing of Cutaneous Abscesseshttps://doi.org/10.1016/j.jemermed.2018.12.009Excluded: serious conflicts of interestN/A

Gottlieb and Peksa,, 2018 [56]Comparison of the Loop Technique with Incision and Drainage for Soft Tissue Abscesses: A Systematic Review and Meta-Analysishttps://doi.org/10.1016/j.ajem.2017.09.007Excluded: older version of updated studyN/A

Long and Gottlieb, 2022 [58]Diagnosis and Management of Cellulitis and Abscess in the Emergency Department Setting: An Evidence-Based Reviewhttps://doi.org/10.1016/j.jemermed.2021.09.015Excluded: Not specific to type II SSTIsN/A