Topical anesthetic cream is associated with spontaneous cutaneous abscess drainage in children

Tara Cassidy-Smith, Rakesh D. Mistry, Christopher J. Russo, Kathryn McCans, Naomi Brown, Lisa M. Capano-Wehrle, Lisa A. Drago, Patty A. Vitale, Brigitte M. Baumann

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Abstract

Objective: The objective of the study was to determine whether use of topical anesthetic cream increases spontaneous drainage of skin abscesses and reduces the need for procedural sedation. Methods: A retrospective multicenter cohort study from 3 academic pediatric emergency departments was conducted for randomly selected children with a cutaneous abscess in 2007. Children up to 18 years of age were eligible if they had a skin abscess at presentation. Demographics, abscess characteristics, and use of a topical analgesic were obtained from medical records. Results: Of 300 subjects, 58% were female and the median age was 7.8 years (interquartile range, 2-15 years). Mean abscess size was 3.5 ± 2.4 cm, most commonly located on the lower extremity (30%), buttocks (24%), and face (12%). A drainage procedure was required in 178 children, of whom 9 underwent drainage in the operating room. Of the remaining 169 children who underwent emergency department-based drainage, 110 (65%) had a topical anesthetic agent with an occlusive dressing placed on their abscess before drainage. Use of a topical anesthetic resulted in spontaneous abscess drainage in 26 patients, of whom 3 no longer required any further intervention. In the 166 patients who underwent additional manipulation, procedural sedation was required in 26 (24%) of those who had application of a topical anesthetic and in 24 (41%) of those who had no topical anesthetic (odds ratio, 0.45; 95% confidence interval, 0.23-0.89). Conclusions: Topical anesthetic cream application before drainage procedures promotes spontaneous drainage and decreases the need for procedural sedation for pediatric cutaneous abscess patients.

Original languageEnglish (US)
Pages (from-to)104-109
Number of pages6
JournalAmerican Journal of Emergency Medicine
Volume30
Issue number1
DOIs
StatePublished - Jan 2012

All Science Journal Classification (ASJC) codes

  • Emergency Medicine

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    Cassidy-Smith, T., Mistry, R. D., Russo, C. J., McCans, K., Brown, N., Capano-Wehrle, L. M., Drago, L. A., Vitale, P. A., & Baumann, B. M. (2012). Topical anesthetic cream is associated with spontaneous cutaneous abscess drainage in children. American Journal of Emergency Medicine, 30(1), 104-109. https://doi.org/10.1016/j.ajem.2010.10.020