Irrigation of cutaneous abscesses

The treatment of cutaneous abscesses classically involves the incision and drainage procedure. Historically, this procedure involves making a linear incision over the abscess cavity, followed by manual expression of cavity contents, blunt dissection to break up loculations, further irrigation with saline, and packing with gauze. However, a lack of data supports the routine use of irrigation to improve the success of the procedure and treatment of the abscess. In addition, while not typically considered, the routine use of irrigation does include some downsides: extra time and supplies, cost, and the possibility of microbiologic contamination of the patient care area and body fluid exposure to the practitioner.

The authors of this study randomized patients to I&D with or without irrigation to determine which method best treated cutaneous abscesses. While there were some differences in the baseline characteristics of the study (higher incidence of packing and ABX usage in the Irrigation Group), these differences would presumably improve the outcomes of these patients; a finding that was not demonstrated. Ultimately, the authors concluded that irrigation of cutaneous abscesses did not decrease the need for further intervention and may not be necessary during an I&D procedure.