Glenn Ian C, Bruns Nicholas E, Craner Domenic, Gibbons Alexander T, Hayek Danial, McNinch Neil L, Soldes Oliver S, Ponsky Todd A
Department of Pediatric Surgery, Akron Children's Hospital, Akron, OH, USA.
Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, OH, USA.
Pediatr Surg Int. 2017 May;33(5):601-604. doi: 10.1007/s00383-017-4070-y. Epub 2017 Feb 22.
Many pediatric centers admit patients following incision and drainage (I&D) of soft-tissue abscesses. The purpose of this study is to assess the safety and efficacy of the same-day discharge following I&D.
Retrospective review was performed of children aged 3 months-4 years who underwent operative I&D of an abscess followed by same-day discharge. Patients receiving antibiotics within 2 weeks of presentation were excluded. Treatment failure was defined as readmission or repeat procedure related to the initial abscess. Statistical analysis was performed using Wilcoxon Rank-Sum and Fisher's Exact tests.
There were 442 procedures performed in 408 patients. Mean age was 1.8 years. Fever was noted in 25.8%. Of those who had a white blood cell (WBC) count drawn, 59.7% had leukocytosis. Mean time from procedure to discharge was 2.3 h, and 85.0% were discharged with oral antibiotics. Treatment failure occurred in four (0.9%) and ten (2.3%) patients at 14 and 30 days, respectively. Mean WBC count was higher in the 14-day treatment failure group (24.1 versus 16.3; p = 0.10). In patients with leukocytosis, there were 2 (1.4%) treatment failures compared to none in those without leukocytosis.
Same-day discharge after I&D of abscess in diaper-age children is safe and effective.
许多儿科中心在对软组织脓肿进行切开引流(I&D)后收治患者。本研究的目的是评估切开引流后当日出院的安全性和有效性。
对年龄在3个月至4岁之间、接受脓肿切开引流手术并于当日出院的儿童进行回顾性研究。排除在就诊后2周内接受抗生素治疗的患者。治疗失败定义为因初始脓肿再次入院或重复手术。采用Wilcoxon秩和检验和Fisher精确检验进行统计分析。
408例患者共进行了442次手术。平均年龄为1.8岁。25.8%的患者出现发热。在进行白细胞(WBC)计数的患者中,59.7%出现白细胞增多。从手术到出院的平均时间为2.3小时,85.0%的患者出院时带口服抗生素。分别有4例(0.9%)和10例(2.3%)患者在14天和30天时出现治疗失败。14天治疗失败组的平均白细胞计数较高(24.1对16.3;p = 0.10)。白细胞增多的患者中有2例(1.4%)治疗失败,而白细胞正常的患者中无治疗失败病例。
尿布期儿童脓肿切开引流后当日出院是安全有效的。