Comparison of Ultrasound-Guided Needle Aspiration and Open Incision and Drainage for Cutaneous Abscesses

Study Overview
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Brief Summary
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The investigators propose to conduct a, two armed, randomized, controlled pilot study to assess the clinical effects of a) open incision, drainage with daily packing changes, compared to b) Ultrasound guided needle aspiration, in drainage of uncomplicated cutaneous abscesses below the skin surface of adult emergency department patients using concealed allocation in evaluating patient satisfaction.

Official Title
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Comparison of Ultrasound-Guided Needle Aspiration and Open Incision and Drainage in the Management of Cutaneous Abscesses

Conditions
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Abscess

Intervention / Treatment
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* Procedure: ultrasound-guided needle aspiration


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients presenting to the Civic Campus emergency department of The Ottawa Hospital with an abscess less than 5 cm diameter, as judged by the attending emergency physician (measurement with tape measure for diameter) between the hours of 7 am and 10 pm will be approached for possible enrollment. Ultrasound will be used to assess the appropriate exclusion criteria. Exclusion Criteria: Patients under the age of 18 years, Patients with a Glasgow coma scale score of <15 (i.e. not completely alert and oriented), Patients suspected of having necrotising fascitis, Patients with hemodynamic instability (defined as SBP <90, and/or HR >110), Patients admitted to hospital, Patients who are neither French nor English speaking, Patients who are not available for telephone follow-up (i.e. homeless). Ultrasound image demonstrates that the abscess is not compressible (generally indicates that the contents of the cyst includes solids, which would not be amenable to aspiration) Ultrasound demonstrates that there is no abscess to manage, Patients with perianal abscesses who have either Crohn's disease or ulcerative colitis or known perirectal fistula, Patients with recurrent abscesses in the same location or abscesses present for more than 2 weeks Patients with complex abscesses including deep tissue, sensitive body part involvement which includes: ears, eyes, lacrimal, orbital, submandibular, mouth, peritonsillar, and Bartholin's gland. Patients with renal impairment, diabetes, immunocompromised (as these patients are at risk of becoming more ill if an abscess were able to grow).

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Ultrasound-guided needle aspiration<br>One arm is ultrasound-guided needle aspiration, the other active comparison is traditional open incision and drainage of skin abscess | Procedure: ultrasound-guided needle aspiration<br>* one time drainage at time of randomization<br>|
| Active Comparator: open incision and drainage<br> | Procedure: ultrasound-guided needle aspiration<br>* one time drainage at time of randomization<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient satisfaction |  | 7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Failure rate |  | 7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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skin abscess, needle aspiration, incision and drainage