Article Instance
API Endpoint for journals.
GET /api/articles/19298/?format=api
{ "pk": 19298, "title": "The Treatment of Cutaneous Abscesses: Comparison of Emergency Medicine Providers' Practice Patterns", "subtitle": null, "abstract": "Objectives: Cutaneous abscesses are commonly treated in the emergency department (ED). Although incision and drainage (I&D) remains the standard treatment, there is little high quality evidence to support additional interventions such as pain control, type of incision, and use of irrigation, wound cultures, and packing. Although guidelines exist to support clinician management of abscesses, they do not clearly specify these additional interventions. This study sought to describe the ED treatments administered to adults with uncomplicated superficial cutaneous abscesses, defined as purulent lesions requiring incision and drainage, that could be managed in an ED or outpatient setting.\nMethods: Four hundred and seventy four surveys were distributed to 15 EDs across the United States. Participants were queried about their level of training and practice environment as well as specific questions regarding their management of cutaneous abscesses in the ED.\nResults: In total, 350 providers responded to the survey (74%). One hundred eighty nine respondents (54%) were attending physicians, 135 (39%) were residents and 26 (7%) were mid-level providers. Most providers (76%) used narcotics for pain management, 71% used local anesthetic over the roof of the abscess, and 60% used local anesthetic in a field block for pain control. Only 48% of responders routinely used irrigation after I&D. Eighty-five percent of responders used a linear incision to drain the abscess and 91% used packing in the wound cavity. Thirty two percent routinely sent wound cultures and 17% of providers routinely prescribed antibiotics. Most providers (73%) only prescribed antibiotics if certain historical factors or physical findings were present on exam. Antibiotic treatment, if used, favored a combination of 2 or more drugs to cover both Streptococcus and methicillin-resistant Staphylococcal aureus (47%). Follow up visits were most frequently recommended at 48 hours unless wound was concerning and required closer evaluation.\nConclusion: Variability exists in the treatment strategies for abscess care. The majority of providers used narcotic analgesics in addition to local anesthetic, linear incisions, and packing. Most providers did not irrigate, order wound cultures, or routinely prescribe oral antibiotics unless specific risk factors or physical signs were present. Limited evidence is available at this time to guide these treatment strategies. [West J Emerg Med. 2013;14(1):23–28.]", "language": "en", "license": { "name": "Creative Commons Attribution-NonCommercial 4.0", "short_name": "CC BY-NC 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc/4.0" }, "keywords": [ { "word": "abscess" }, { "word": "incision and drainage" }, { "word": "MRSA" }, { "word": "Guidelines" }, { "word": "Bacterial Infections and Mycoses" }, { "word": "Skin and Connective Tissue Diseases" } ], "section": "Practice Variability", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/76x7z0hw", "frozenauthors": [ { "first_name": "Gillian", "middle_name": "R", "last_name": "Schmitz", "name_suffix": "", "institution": "University of California at San Diego, Department of Emergency Medicine, San Diego, California", "department": "None" }, { "first_name": "Tress", "middle_name": "", "last_name": "Goodwin", "name_suffix": "", "institution": "Washington Hospital Center, Department of Emergency Medicine, Washington, DC", "department": "None" }, { "first_name": "Adam", "middle_name": "", "last_name": "Singer", "name_suffix": "", "institution": "Stony Brook University and Medical Center, Department of Emergency Medicine, Stony Brook, New York", "department": "None" }, { "first_name": "Chad", "middle_name": "S.", "last_name": "Kessler", "name_suffix": "", "institution": "Jesse Brown VA Medical Center, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "David", "middle_name": "", "last_name": "Bruner", "name_suffix": "", "institution": "Naval Medical Center, Department of Emergency Medicine, Portsmouth, Virginia", "department": "None" }, { "first_name": "Hollynn", "middle_name": "", "last_name": "Larrabee", "name_suffix": "", "institution": "West Virginia University, Department of Emergency Medicine, Morgantown, West Virginia", "department": "None" }, { "first_name": "Larissa", "middle_name": "", "last_name": "May", "name_suffix": "", "institution": "George Washington University, Department of Emergency Medicine, Washington, DC", "department": "None" }, { "first_name": "Samuel", "middle_name": "D.", "last_name": "Luber", "name_suffix": "", "institution": "University of Texas Health Science Center at Houston, Department of Emergency Medicine, Houston, Texas", "department": "None" }, { "first_name": "Justin", "middle_name": "", "last_name": "Williams", "name_suffix": "", "institution": "University of Texas Health Science Center at San Antonio, Department of Emergency Medicine, San Antonio, Texas", "department": "None" }, { "first_name": "Rahul", "middle_name": "", "last_name": "Bhat", "name_suffix": "", "institution": "Washington Hospital Center, Department of Emergency Medicine, Washington, DC", "department": "None" } ], "date_submitted": "2011-07-19T04:30:38Z", "date_accepted": "2011-07-19T04:30:38Z", "date_published": "2012-11-17T07:22:01Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/19298/galley/9546/download/" } ] }