Acute Abscess Management – A Prospective 1-Year Single-Centric Randomized Control Trial For Comparison Between Primary Closure Of Superficial Abscess Versus Healing Of Abscess By Secondary Intention

Abstract

Background and objectives: Acute abscess is amongst the common conditions to occur in the field of surgery. The conventional method of abscess management i.e. healing of abscess by secondary intention has disadvantages such as periodic dressing changes, painful dressings, delayed wound healing, prolonged hospitalization. However, closure of abscess cavity can also be achieved via suturing the skin and placing a negative pressure drain in the abscess cavity to promote obliteration of the cavity and wound healing i.e. healing by primary closure. This method of closure does not have the above mentioned disadvantages Materials and methods This one year randomized controlled trail was done in Department of General Surgery, KLES Dr.Prabhakar Kore hospital, Belagavi from January 2018 to December 2018. A total of 60 patients with an acute superficial abscess were included in this study. These patients were divided into two groups of 30 each that is Group A (Abscess closure by Healing with Secondary Intention) and Group B (Abscess closure by Primary Intention and placing a negative pressure drain). Results Amongst the 60 cases studied, the patients were evenly distributed amongst all age groups with a mean age of 47 years. Majority of the abscesses were gluteal abscesses in the study (18) followed by breast abscesses (10). The mean duration of hospital stay was 8 days in primary closure whereas it was 10 days in secondary healing group with a p-value of 0.256(not significant). The number of dressings required in primary closure group was found to be significantly less, with a mean of 5-6 dressings as compared to 16 dressings in secondary healing with a p-value of 0.0001 (statistically significant). The mean wound healing time was about 11 days in primary closure group as compared to 15 in secondary healing group with a p-value of 0.0001 (statistically significant) Conclusion Primary closure is suitable for all superficial abscesses under antibiotic cover, and the results were excellent when it came to mean healing time and the number of dressings required between the two groups. Hence, the method of primary closure of an abscess may be considered as an acceptable method when it comes to superficial abscesses