Improving Outcomes, Improving Throughput, Mythbusting

Had an abscess packed? Call now!

It’s a generally accepted FOAM principle that packing an abscess is of no benefit, but now we can add one more reason onto why we should not do this:

An impressively high rate of recurrence!

In this study of 272 patients with roughly 83% of patients having the unpleasant packing experience (!!) the adjusted OR for recurrence: 4.64. (coincidentally, there was also an 83% 1 week follow up and 71% follow up at either 1 or 3 months). Overall recurrence rate was about 28% within 3 months. The only two variables associated with a recurrence? A prior abscess within the last 2 months, and a prior abscess within the last 3-6 months.

So… Not HIV status, not the presence of diabetes… Nope. Just the lack of the providers FOAM knowledge base about wound packing will bump up your likelihood of recurrence. Perhaps they had larger abscesses, but given that abscess size and amount of erythema was not significantly correlated with recurrence, I doubt it.

Per the authors: “The reasons for this latter observation is unclear; however, other studies have shown that this practice may not improve outcomes and can lead to increased pain… Interestingly, packing was associated with increased recurrence, warranting further investigation of this practice.”

Or we could just stop doing it altogether. Cant you just see a late night TV ad? If you’ve had an abscess packed, then had another one within three months, call us now! You may be entitled to a settlement! Operators are standing by!

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