Minimally Invasive Drainage of Subcutaneous Abscesses Reduces Hospital Cost and Length of Stay

Wright, Tiffany; Gilligan, Leah A; Zhurbich, Oksana; Davenport, Daniel L.; Draus, John M.

doi:10.1097/smj.0000000000000032

Cited by 20 publications

(31 citation statements)

References 11 publications

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“…23 Another study comparing LDT with CID among hospitalized patients found that the LDT patients experienced a significantly shorter hospital length of stay, which directly translated to reduced health care costs. 24 While no statistically significant difference was identified in the pediatric and adult subgroups, it is worth noting that both populations had a larger number of treatment failures overall in the CID group when compared with the LDT group (absolute differences = 6.82% and 8.22%, respectively). This is further limited by differences in overall treatment failure rates regardless of intervention between adult and pediatric patients.…”

Section: Discussionmentioning

confidence: 75%

Comparison of the Loop Technique With Incision and Drainage for Skin and Soft Tissue Abscesses: A Systematic Review and Meta‐analysis

Gottlieb

Schmitz

Peksa

2020

Academic Emergency Medicine

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Background: Cutaneous abscesses are common presentations to the emergency department. While the primary treatment for most abscesses is conventional incision and drainage (CID), this is painful and can lead to multiple return visits. The loop drainage technique (LDT) has been proposed as an alternate, less-invasive approach to abscess management. The primary outcome of this study was to compare LDT with CID for skin and soft tissue abscesses. Methods: PubMed, Scopus, CINAHL, LILACS, Google Scholar, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and bibliographies of selected articles were assessed for all retrospective, prospective observational, and randomized controlled trials comparing treatment failures between LDT and CID among patients with skin and soft tissue abscesses. Data were dual extracted into a predefined worksheet and quality analysis was performed using the Cochrane Risk of Bias tool or the Newcastle-Ottawa scale. Data were summarized and presented as odds ratios (ORs) with 95% confidence intervals (CIs). Subgroup analyses were performed for adult and pediatric patients. Results: A total of 1,374 studies were identified with eight studies (n = 910 patients) selected for inclusion. Overall, CID failed in 69 of 487 patients (14.17%), while LDT failed in 35 of 423 patients (8.27%). There was an OR of 2.02 (95% CI = 1.29 to 3.18) in favor of higher failures in the CID group. This finding remained consistent with only randomized controlled trials (OR = 1.75, 95% CI = 1.07 to 2.86), but no difference was identified in the adult or pediatric subgroups. Conclusion: The LDT was associated with reduced treatment failures when compared with CID. Future studies should further assess the impact on pain, cosmetic outcomes, and health care costs.

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Section: Discussionmentioning

confidence: 75%

Comparison of the Loop Technique With Incision and Drainage for Skin and Soft Tissue Abscesses: A Systematic Review and Meta‐analysis

Gottlieb

Schmitz

Peksa

2020

Academic Emergency Medicine

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“…Growth in inpatient hospital costs is the biggest driver of rising health care expenditure [12], and between 2007 and 2014, hospital prices for inpatient care grew by 42%, markedly more than the growth in physician prices [12]. Image-guided, minimally invasive procedures, per se, provide cost-effective, high-value care [1,4,13]. IR procedures, used as a substitute for or in addition to surgery, offer cost savings by decreasing the total cost of therapy and reducing LOS [1,3,4].…”

Section: Discussionmentioning

confidence: 99%

“…Several IR procedures improve upon conventional surgical options, rooted in similar efficacy but with less morbidity. Thus, its minimal invasiveness is associated with cost savings because of its reduced dependency on resource-intense critical care units and shorter length of stay (LOS) [1,4].…”

Section: Introductionmentioning

confidence: 99%

The Economic Footprint of Interventional Radiology in the United States: Implications for Systems Development

Shah

Tennakoon

O’Beirne

et al. 2021

Journal of the American College of Radiology

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“…Adopting this practice would mean that many more abscesses can be treated with local anaesthetic and therefore would not require hospital admission. This would also reduce costs in the community caused by regular packing and be more convenient for patients [ 12 ]. There is evidence that packing abscesses although practised widely may interfere with wound healing and is no longer recommended for most abscesses [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Management of Superficial Abscesses: Scope for Day Case Surgery

Nixon

Akoh

2014

Surgery Research and Practice

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Background. Patients presenting with superficial abscesses are often regarded as low priority and given a less efficient service. Aim. The aim of this study was to investigate the efficiency of emergency treatment of superficial abscesses and to identify areas for service improvement. Method. A retrospective case review of patients admitted to Derriford Hospital, Plymouth, over a four-month period. Results. Ninety-seven patients were included in the study. Seventy two (74%) arrived between 08.00 and 16.00 hours. Overall, 75 patients (77%) were referred on weekdays with 22 patients (23%) during weekends. Seventy-two patients (74%) had treatment under a general anaesthetic. Sixty-three percent of operations occurred within the working day. The time interval between admission and surgery ranged from 52 minutes to 38 hours (mean ± SD 16 ± 9.15). The length of admission ranged from 5.3 hours to 11 days (mean 36 hours). Of the one hundred overnight beds used by the 97 patients, 30 nights were spent awaiting surgery and 70 following surgery and awaiting discharge. Conclusion. Eighty-nine percent of the patients would have been suitable for treatment as day cases. This review shows that a simple service redesign has the potential of reducing inpatient bed occupancy and improving the patient's journey.

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Minimally Invasive Drainage of Subcutaneous Abscesses Reduces Hospital Cost and Length of Stay

Cited by 20 publications

References 11 publications

Comparison of the Loop Technique With Incision and Drainage for Skin and Soft Tissue Abscesses: A Systematic Review and Meta‐analysis

Comparison of the Loop Technique With Incision and Drainage for Skin and Soft Tissue Abscesses: A Systematic Review and Meta‐analysis

The Economic Footprint of Interventional Radiology in the United States: Implications for Systems Development

Management of Superficial Abscesses: Scope for Day Case Surgery

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