skin abscesses treatment
review article in new england journal this week on management of skin abscesses in era of methicillin-resistant staph aureaus MRSA (see skin abscesses mrsa review nejm 201 4 in dropbox or DOI: 10.1056/NEJMra1212788). both the incidence of skin abscesses overall and the % of MRSA have increased over time. a few comments: --diagnostic accuracy is not great: eg, a study of 126 adults with cellulitis where ER MD felt abscess not evident, ultrasound found abscess in 50% --treatment of abscess is primarily I&D --there may be more rapid healing if the I&D incision is closed vs leaving it open (studies mostly in the anogenital area, showing half the healing time and no diff in recurrences). should consider primary closure if incision >2cm. [goes against conventional wisdom that needs to be open to continue draining] --no data as to whether to irrigate the wound, and data on whether packing...