- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01897675
A Comparison of Techniques for Treating Skin Abscesses (LoopDrainage)
Is Loop Drainage of a Cutaneous Abscess in the Emergency Department as Effective as Incision and Drainage With Packing?
Management of abscesses traditionally involves incision and drainage (I&D). Abscesses are frequently are "packed" or stented open with the presence of a wick, and traditional care requires re-visits every 2-3 days to have the packing removed and replaced, until finally the abscess cavity has closed, usually 1-2 weeks after initial presentation.
Recently there have been attempts to employ less invasive techniques for abscess management. One novel technique, "loop drainage", has been reported in case reports/case series for management of a variety of types of abscesses in the surgical subspecialty literature.
We propose to conduct a randomized prospective study comparing the efficacy of the loop drainage technique with the traditional incision and drainage technique of abscess management.
Patients presenting to the main or urgent care areas of the Emergency Department at Boston Medical Center for treatment of an abscess will be considered for enrollment as potential subjects. After the treating clinician identifies the patient as an appropriate subject, a Research Associate (RA) will approach the patient and obtain written informed consent to enroll in the study. The subject will then be randomized to the management arm of either loop drainage or traditional I&D. The clinician will fill out a data sheet describing the abscess characteristics, and then perform either loop drainage or incision and drainage, depending on randomization and the subject will fill out a satisfaction survey. Fourteen days after initial visit, subjects will return for follow-up. The subject will fill out a satisfaction survey, and a study investigator blinded to the treatment group will assess the subject for abscess resolution, cosmetic outcome, number of follow-up visits, and complications.
The study investigators will then compare outcomes between the two study groups.
Study Overview
Status
Conditions
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
Massachusetts
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Boston, Massachusetts, United States, 02118
- Boston University Medical Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Adult patient over 18 years of age
- Presenting to the Boston Medical Center main Emergency Department or Urgent Care area for initial treatment of a skin abscess
- English speaking
- Able to provide written informed consent
- Willing to return in 14 days for follow-up visit
- Able to give a telephone number for follow-up contact
Exclusion Criteria:
- Previously treated for this abscess
- Altered mental status
- Patients with active psychiatric issues that preclude their ability to provide informed consent
- Previously enrolled in the study
- Abscess is not amenable to treatment by an Emergency Physician in the Emergency Department
- Abscess is post-operative or post-procedure
- Clinician determines abscess is not amenable to drainage by particular method
- Abscess is too small for packing or loop
- Need for hospital admission
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Incision and Drainage with Packing
Abscess is cared for in the standard fashion, using an incision and drainage with packing (wick) placement.
Packing to be changed every 2-3 days, at the discretion of the treating clinician, until abscess is considered resolved
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EXPERIMENTAL: Loop Drainage
Abscess is cared for using a minimally invasive abscess drainage with loop placement technique.
Two (or more) stab incisions are made in the abscess, the cavity is probed and pus is drained, and a vessel loop is inserted and tied off.
The patient manipulates the loop 3 times per day, and removes the loop when all redness is gone and no more pus is present
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Abscess Resolution
Time Frame: 14 days
|
If no, which sign is present (check all that apply):
|
14 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patient Satisfaction Immediately After Procedure
Time Frame: Time 0
|
How Satisfied is Patient Immediately after Procedure (likert scale) Did Patient Feel Discomfort During Procedure (likert scale)
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Time 0
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Cosmetic Outcome
Time Frame: 14 days
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Appearance according to wound scale Wound Scale (presence or absence of)
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14 days
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Patient Satisfaction after Abscess Resolution
Time Frame: 14 Days
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Patient Satisfaction with: Number of Follow Up Visits (likert scale) Cosmetic Appearance (likert scale) Pain (likert scale) Overall abscess care (likert scale |
14 Days
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Number of Follow Up Visits
Time Frame: 14 days
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Number of follow-up visits made to either Emergency Department or outpatient clinic for abscess care
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14 days
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Number of Complications
Time Frame: 14 days
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need for new incision in the same abscess, extension of the original incision, starting antibiotics, changing antibiotics, admission
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14 days
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Elissa Schechter-Perkins, MD, MPH, Boston Medical Center
Publications and helpful links
General Publications
- McNamara WF, Hartin CW Jr, Escobar MA, Yamout SZ, Lau ST, Lee YH. An alternative to open incision and drainage for community-acquired soft tissue abscesses in children. J Pediatr Surg. 2011 Mar;46(3):502-6. doi: 10.1016/j.jpedsurg.2010.08.019.
- Ladd AP, Levy MS, Quilty J. Minimally invasive technique in treatment of complex, subcutaneous abscesses in children. J Pediatr Surg. 2010 Jul;45(7):1562-6. doi: 10.1016/j.jpedsurg.2010.03.025.
Helpful Links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- H-32294
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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