Author/date/region of study Hawker score/36 Intervention (s) of study Study population sample size Methods Duration of study Outcome measurements Findings Llera et al. [68 ], USA 22 Incision and drainage Adult 78 Observational study 3 months Patient characteristics, outcomes/complications of incision and drainage 27% recurrence rate following incision and drainage, concluded as the treatment of choice, and study concluded the use of antibiotics were not beneficial in their patient group Eryilmaz et al. [69 ], Turkey 26 Needle aspiration vs incision and drainage Adults 45 Prospective cohort study 3.5 years Cure rate Aspiration group failed to demonstrate resolution Healing time Improved healing time with aspiration ( Tsoraides et al. [70 ], USA 25 Loop drainage Children 115 Retrospective cohort study 5 years 9 months Complications Successful loop drainage in 94.5% of cases. The mean length of stay 3 days Length of stay McNamara et al. [65 ], USA 32 Loop drainage vs incision and drainage Children 219 Retrospective cohort study 7 months Complications Reduced complication rate (0 vs 4 cases) Length of stay Length of stay not significant ( Wound care, cosmetics, pain Reduced community wound care. (51.5% vs 0%- Alder et al. [64 ], USA 27 Catheter drainage vs incision and drainage Children 400 Intention to treat cohort study 1.5 years Treatment failure Treatment failure not significant ( Complications Length of stay Postoperative wound care, pain, follow-up Gaspari et al. [19 ], USA 29 Needle aspiration vs incision and drainage Adults 101 Randomised controlled trial 15 months Treatment failure Increased treatment failure with needle aspiration (74% vs. 20%) 47% increased failure rate in patients with CA-MRSA who underwent needle aspiration Singer et al. [67 ], international 34 Incision and drainage with primary closure 915 participants across seven studies Systematic literature review and meta-analysis Unclear Time to healing recurrence rates, return to work Primary closure reduced wound healing time (7.8 days vs 15 days) and allowed for an earlier return to work (4.1 days vs 14.6 days). Similar complication and recurrence rates Winstead [71 ], USA 24 Management of uncomplicated skin and soft tissue infections caused by Staphylococcus aureus N/A Literature review Unclear Relevant published literature 2003–2008 Recommendations for incision and drainage only for the treatment of uncomplicated SSTIs in low-risk patients. Incision and drainage combined with antibiotic therapy should be used to manage all high-risk patients Singer and Talan [72 ], USA 24 Incision and drainage N/A Literature review article Unclear Diagnosis, treatment, irrigation, packing, primary vs secondary closure, antibiotics, MRSA Advocates ultrasound diagnosis, traditional incision and drainage as the mainstay treatment option, routine wound packing unnecessary, alternative practices to be considered in ‘appropriate cases. Limiting antibiotics and wound culture practices Ladde et al. [73 ], USA 34 Loop drainage vs incision and drainage Children 142 Retrospective study 12 months Treatment failure Incision and drainage group 17% vs loop drainage group 4% ( Mahida et al. [74 ], USA 27 Straight drain vs loop drain Children 681 Intention to treat quality improvement study 2 years 1 month Uptake of straight drain, treatment failure, outpatient follow-up demand, clinical, and nursing education 78% uptake in favour of straight drainage ( Nonsignificant decrease in treatment failure Significant reduction in outpatient follow-up Rencher et al. [66 ], USA 31 Loop drainage vs incision and drainage Children 81 Prospective, nonblinded, randomised controlled trial 18 months Treatment failure, wound appearance, parent satisfaction Demonstrated noninferiority of the loop drainage technique Treatment failure (7.3% loop vs 7.5%) Cosmetic appearance at day 14 (6 vs. 6 Parent satisfaction rates (86.1% of the loop arm vs 88.2% of the standard arm Pain reduction after procedures was similar ( Lasithotakis et al. [32 ], UK 31 Needle aspiration Adults 100 Prospective cohort study 4 years Treatment failure Successful aspiration in 83% of patient group Pain, aesthetics, procedural satisfaction High level of aesthetic satisfaction (9/10) Improved pain postaspiration (9/10 to 5.5/10) Özturan et al. [75 ], Turkey 28 Loop drainage vs incision and drainage Adults 46 Randomised controlled trial 1 year 10 months SSTI resolution Resolution rate not significant ( Adverse events aesthetics, antibiotics Nonsignificance in secondary outcomes Yang et al. [33 ], China 33 Suction drainage vs incision and drainage Children 1430 Randomised controlled trial 4 years Pain Statistically significant reduction in pain Length of stay No statistically significant difference in length of stay Treatment failure Significant improvement in treatment time to resolution Wound care, pain Long and April [76 ], international 19 Loop drainage vs incision and drainage 460 participants across four studies Meta-analysis Unclear Treatment failure Incision and drainage failed in 9.43% of cases of cases compared with the loop drainage technique in 4.10% of cases Schechter-Perkins et al. [21 ], USA 32 Loop drainage vs incision and drainage Adults and children 238 Randomised controlled trial 3 years 7 months Clinical resolution complications, antibiotics Clinical resolution not significant Reduced additional emergency department attendances (1.3 days vs 1.8 days) Lower complication rate (9.3% vs. 24.6%) Significant reduction in antibiotic requirements (1.3% vs 12.3% Zhimin et al. [77 ], China 23 Suction drainage vs incision and drainage Adults 47 Cohort study 1 year Wound healing time Statistically significant in wound healing time Recurrence No statistical significance in abscess recurrence Wound care Reduced number of wound care requirements Gottlieb [57 ], USA 34 Loop drainage vs incision and drainage 910 participants across eight studies Systematic review and meta-analysis Unclear Treatment failure Incision and drainage group 14.7% vs loop drainage group 8.27% (95% CI)
