López Julio, Gómez Gilberto, Rodriguez Karime, Dávila Julio, Núñez José, Anaya Luis
1 Department of Surgery, Mexican Institute of Social Security , Delicias, Mexico .
2 Emergency Department, Mexican Institute of Social Security , Delicias, Mexico .
Surg Infect (Larchmt). 2018 Apr;19(3):345-351. doi: 10.1089/sur.2017.225. Epub 2018 Mar 13.
Skin and soft tissue infections are common problems dealt with in emergency departments and medical offices. It is routine practice to prescribe antibiotic agents after incision and drainage of cutaneous abscesses. However, current evidence does not support prescribing oral antibiotic agents after surgical debridement. The aim of the present study was to determine the actual role of antibiotic agents after drainage of cutaneous abscesses.
This was a prospective study of patients undergoing incision and drainage (I&D) of a subcutaneous abscess. Patients were randomly assigned either to receive antibiotic agents (group 1) or placebo (group 2) after I&D. The primary end point was resolution rate of the abscess at the seventh day. Secondary end points were pain at the seventh day and total time to full healing of the wound. P value <0.05 was considered statistically significant.
One hundred sixty-five patients were included for analysis. Age, gender, body mass index (BMI), and comorbidities did not differ substantially between groups. Chest and peri-anal abscesses were statistically more frequent in group 2, whereas neck abscesses were more frequent in group 1 (p = 0.02). Leukocyte count was also statistically higher in group 1 (p = 0.005). Resolution rate was 96% in group 1 and 93% in group 2, with no statistical difference between both (p = 0.28). Neither pain at seventh day nor time to full healing differed statistically between groups.
Antibiotic agents are not necessary for uncomplicated subcutaneous abscesses after I&D. These cases can be managed safely on an outpatient basis without any increase in morbidity.
皮肤和软组织感染是急诊科和医务室常见的问题。在切开引流皮肤脓肿后开具抗生素是常规做法。然而，目前的证据并不支持在手术清创后开具口服抗生素。本研究的目的是确定皮肤脓肿引流后抗生素的实际作用。
这是一项对接受皮下脓肿切开引流术（I&D）患者的前瞻性研究。患者在I&D后被随机分配接受抗生素（第1组）或安慰剂（第2组）。主要终点是脓肿在第7天的消退率。次要终点是第7天的疼痛情况以及伤口完全愈合的总时间。P值<0.05被认为具有统计学意义。
165例患者纳入分析。两组在年龄、性别、体重指数（BMI）和合并症方面无显著差异。第2组胸部和肛周脓肿在统计学上更为常见，而第1组颈部脓肿更为常见（p = 0.02）。第1组白细胞计数在统计学上也更高（p = 0.005）。第1组的消退率为96%，第2组为93%，两组之间无统计学差异（p = 0.28）。两组在第7天的疼痛情况和完全愈合时间在统计学上均无差异。
对于I&D后的非复杂性皮下脓肿，抗生素并非必需。这些病例可在门诊安全处理，且发病率不会增加。
