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.

After incision and drainage plain 1/4-1/2 inch gauze packing material is placed into the cavity to fill it

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

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.

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