Primary Closure of Abscesses Versus Conventional Incision and Drainage

Abstract

Objective: To determine reliability of primary closure of abscesses verses conventional incision and drainage. Study Design: Comparative study. Settings: DHQ Hospital, Independent University Hospital Faisalabad-Pakistan. Duration: Two years, 2017 to 2019. Conventional incision and drainage with wound packing is still being widely practiced despite innovative broad spectrum antibiotic coverage availability. The purposes of innovative primary closure procedure after incision and drainage and meticulous wound cleansing with normal saline covered by broad-spectrum prophylactic and post-operative antibiotics is to reduce morbidity and cost related to the more conventional procedure. Methodology: Comparison of two procedures that i.e. conventional incision and drainage with wound packing and incision and drainage with primary closure. The results were observed in patients including author's recent practice undergoing primary closure after incision and drainage from December 2017 to July 2019. The data was collected from DHQ Hospital, Independent University Hospital Faisalabad from year 2017 to 2019. Group 1 included patients with primary closure and group 2 included patients undergoing conventional incision and drainage. Results: Results of both procedures were compared in terms of morbidity i.e. recurrence, wound infection, cost and final scar results. In group 1 recurrence was observed in one patient (2%). It was observed that post-operative wound infection occurred in two patients (4%) that settled with antibiotic cover. Lesser number of average hospitals stay which the author found to be just 0- 1 day. The healing time was observed to be 7-10 days. In the group 2, there was no difference in recurrence of abscess which was found to be 2%-3%. The wound infection was observed 4% which was like group 1. On the other hand, the patients had to stay hospital for 4-5 days.  Daily painful dressings requiring I.V analgesia and psychological trauma related to open wound. The average healing time was extended to of 4-6 weeks. Conclusion: Primary closure of abscesses versus conventional incision and drainage is more beneficent.