Abscess Packing Versus Wick Placement After Incision and Drainage

Abscesses or "boils" are becoming more common every year and are a common reason children come to the Emergency Department. For the abscess to heal the skin needs to be opened to let the pus come out. Often doctors put something called "packing material" or gauze into the abscess space to help aid in healing. It is not known if the type of "packing" that is done is necessary or if a more simple treatment is as good or better. With informed consent we randomly place a child into one (1) of two (2) groups in this study that will say if the child's abscess/boil is packed with gauze in the traditional way or if a wick (small piece) of gauze is placed after the abscess/boil is opened and the fluid is drained. After treatment in the emergency department the child will be scheduled to follow-up in the Pediatric Acute Wound Service (PAWS) clinic as all other children with this infection are scheduled. At this visit the healing of the wound will be checked by the staff in the clinic and will be scored. With this evaluation of the wound the hypothesis that for a simple superficial (skin) abscess/boil a gauze wick placement into the abscess/boil is as effective as placement of traditional gauze packing.

Study Overview

• Status: Completed
• Conditions: Superficial Abscess Packing
• Intervention / Treatment: Procedure: Wick placement into abscess cavity; Procedure: Full packing into abscess cavity

• Study Type: Interventional
• Enrollment (Actual): 156
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Missouri
    • Saint Louis, Missouri, United States, 63110
      • St. Louis Children's Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 6 months to 18 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Well appearing patient
• Abscesses restricted to the superficial areas of the extremities, buttocks, abdominal and thoracic walls, and back
• Patients presenting Saturday-Wednesday

Exclusion Criteria:

• Fever >38 degrees celsius
• Ill appearing patient
• Underlying immunodeficiency or disorder leading to chronic abscess formation
• Any reason for admission to hospital beyond the need for sedation at the time of follow-up
• Thursday-Friday

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Wick placement into abscess cavity	Procedure: Wick placement into abscess cavity; After incision and drainage of the abscess a piece of plain gauze 1/4-1 inch packing material that is as wide as can be easily passed through the opening is placed into the cavity spanning one diameter of the cavity
Active Comparator: Full packing of abscess cavity	Procedure: Full packing into abscess cavity; After incision and drainage plain 1/4-1/2 inch gauze packing material is placed into the cavity to fill it

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Abscess healing based upon clinical criteria and clinical judgement	Abscesses are assessed for pus accumulation, erythema from the wound, if the patient has a fever and the overall clinical judgment of the evaluating health care professional at the time of follow-up.	24-72 hours

Secondary Outcome Measures

Outcome Measure	Time Frame
Pain since abscess drainage	24-72 hours
Parent/guardian comfort with removing the packing material or wick from the abscess cavity	24-72 hours
Parent/guardian assessment of the abscess wound at 2 weeks	2 weeks
Parent/guardian assessment of pus drainage at 2 weeks	2 weeks
Need for further treatment of same abscess within 2 weeks	2 weeks

Collaborators and Investigators

• Sponsor: Washington University School of Medicine

Study record dates

Study Major Dates

• Study Start: June 1, 2009
• Primary Completion (Actual): November 1, 2015
• Study Completion (Actual): November 1, 2015

Study Registration Dates

• First Submitted: January 20, 2011
• First Submitted That Met QC Criteria: January 20, 2011
• First Posted (Estimate): January 24, 2011

Study Record Updates

• Last Update Posted (Actual): June 19, 2018
• Last Update Submitted That Met QC Criteria: June 15, 2018
• Last Verified: June 1, 2018

More Information

Terms related to this study

• Keywords: incision and drainage; Superficial abscess; packing material; wick
• Additional Relevant MeSH Terms: Pathologic Processes; Infections; Inflammation; Suppuration; Abscess
• Other Study ID Numbers: 09-0719 -201103241