Abscess Packing Versus Wick Placement After Incision and Drainage

• ClinicalTrials.gov Identifier: NCT01281930
• Recruitment Status: Completed
• First Posted: January 24, 2011
• Last Update Posted: June 19, 2018
• Sponsor: Washington University School of Medicine
• Information provided by (Responsible Party): Washington University School of Medicine

Study Description

Brief Summary:

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.

Condition or disease	Intervention/treatment	Phase
Superficial Abscess Packing	Procedure: Full packing into abscess cavity; Procedure: Wick placement into abscess cavity	Not Applicable

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 156 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Triple (Participant, Care Provider, Outcomes Assessor)
• Primary Purpose: Treatment
• Official Title: Abscess Packing Versus Wick Placement After Incision and Drainage
• Study Start Date: June 2009
• Actual Primary Completion Date: November 2015
• Actual Study Completion Date: November 2015

Arms and Interventions

Arm	Intervention/treatment
Experimental: Wick placement into abscess cavity	Procedure: Wick placement into abscess cavity; 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
Active Comparator: Full packing of abscess cavity	Procedure: Full packing into abscess cavity; After incision and drainage plain 1/4-1/2 inch gauze packing material is placed into the cavity to fill it

Outcome Measures

Primary Outcome Measures :

1. Abscess healing based upon clinical criteria and clinical judgement [ Time Frame: 24-72 hours ]
   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.

Secondary Outcome Measures :

1. Pain since abscess drainage [ Time Frame: 24-72 hours ]
2. Parent/guardian comfort with removing the packing material or wick from the abscess cavity [ Time Frame: 24-72 hours ]
3. Parent/guardian assessment of the abscess wound at 2 weeks [ Time Frame: 2 weeks ]
4. Parent/guardian assessment of pus drainage at 2 weeks [ Time Frame: 2 weeks ]
5. Need for further treatment of same abscess within 2 weeks [ Time Frame: 2 weeks ]

Eligibility Criteria

• Ages Eligible for Study: 6 Months to 18 Years (Child, Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

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

Contacts and Locations

Locations

United States, Missouri

St. Louis Children's Hospital

Saint Louis, Missouri, United States, 63110

Sponsors and Collaborators

Washington University School of Medicine

More Information

• Responsible Party: Washington University School of Medicine
• ClinicalTrials.gov Identifier: NCT01281930
• Other Study ID Numbers: 09-0719 -201103241
• First Posted: January 24, 2011
• Last Update Posted: June 19, 2018
• Last Verified: June 2018

Keywords provided by Washington University School of Medicine:

Superficial abscess; packing material; wick; incision and drainage

Additional relevant MeSH terms:

Abscess; Suppuration; Infections; Inflammation; Pathologic Processes