Evidence Based Abscess Management

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Management of Skin Abscesses in the Era of Methicillin-Resistant Staphylococcus aureus

Adam J. Singer, M.D., and David A. Talan, M.D.

N Engl J Med 2014; 370:1039-1047

The authors of this article summarize the literature thusly:

  1. Incision & drainage is definitive treatment. Non-complicated disease does not require additional antibiotic treatment, although the evidence is not strong.
  2. Packing of abscesses is a matter of tradition, and evidence is neither sufficient to conclusively confirm nor refute this practice.
  3. Primary closure of abscesses after I&D is reasonable, particularly for larger, exposed, and cosmetically important areas.
  4. Antibiotic coverage for primarily cellulitic soft-tissue infections ideally includes streptococcal coverage
  5. Wound cultures are not necessary.