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    Ultrasound-Guided Drainage for Pediatric Soft Tissue Abscesses Decreases Clinical Failure Rates Compared to Drainage Without Ultrasound: A Retrospective Study

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    Authors
    Gaspari, Romolo Joseph
    Sanseverino, Alexandra
    UMass Chan Affiliations
    Department of Emergency Medicine
    Document Type
    Journal Article
    Publication Date
    2017-07-21
    Keywords
    abscess
    point-of-care ultrasound
    soft tissue ultrasound
    ultrasound-guided drainage
    Emergency Medicine
    
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    Link to Full Text
    https://doi.org/10.1002/jum.14318
    Abstract
    OBJECTIVES: Soft tissue abscesses are common in the pediatric emergency department (ED). Ultrasound (US) can be used to both diagnose soft tissue abscesses as well as guide drainage. We hypothesized that clinical failure rates would be less in pediatric patients with suspected skin abscesses when evaluated with US. METHODS: We performed a retrospective review of suspected pediatric skin abscesses at 4 EDs over a 22-month period. Cases were identified through electronic medical record descriptions, discharge diagnoses, and US database records. Data on US use, findings, and outcomes were abstracted to an electronic database. Comparisons between groups included US versus non-US (primary outcome) as well as surgical drainage vs nonsurgical drainage (secondary outcome). RESULTS: A total of 377 patients were seen with concern for a potential skin abscess; 141 patients (37.4%) underwent US imaging during their visit, and 239 (63.4%) underwent incision and drainage (IandD) during their ED stay: 90 with US and 149 without. The failure rate for patients evaluated with US was significantly lower than that for those evaluated without US (4.4% versus 15.6%; P < .005). Thirty-four (11.3%) of the 302 patients with a diagnosis of an abscess failed therapy: 19 (8.2%) after IandD and 15 (21.1%) after nonsurgical management. Failure after IandD was associated with a smaller abscess cavity on US imaging (17.2 versus 44.8 mm3 ; P < .05). CONCLUSIONS: The use of US for patients with a suspected skin abscess was associated with a reduction in the amount of clinical failure rates after both surgical drainage and nonsurgical therapy. Ultrasound should be used when evaluating or treating patients with abscesses.
    Source
    J Ultrasound Med. 2017 Jul 21. doi: 10.1002/jum.14318. [Epub ahead of print] Link to article on publisher's site
    DOI
    10.1002/jum.14318
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/28548
    PubMed ID
    28731535
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1002/jum.14318
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    UMass Chan Faculty and Researcher Publications
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