Loop Drainage Technique vs. Conventional Incision and Drainage for Management of Skin and Soft Tissue Abscesses: Systematic Review and Meta-analysis

Author(s):

Abdullah Saud Alsayed*, Abdulellah Ibrahim Al homoudi, Yasser Zaid Alkhalaf, Abdulaziz Mohammed Alomaysh, Naif Mohammed Aleid, Saud Abdulrahman Alzahrani, Yousef Hamoud Almutairi and Mshari Ahmed Othman Alassaf

Background: The loop approach is an alternative to packing that does not require large incisions can be used in both small and big abscesses, preventing premature closure and fostering prolonged drainage in the same way as packing does. Aim: This work aims to determine the efficacy and safety of the Loop Drainage Technique (LDT) versus Conventional Incision and Drainage (CID) for the management of skin and soft tissue abscesses. Materials & Methods: A systematic search was performed over different medical databases to identify general surgery studies, which studied the outcome of the LDT group versus the CID group of skin and soft tissue abscesses patients. We conducted a meta-analysis process on the overall failure rate as a primary outcome (failure is defined as the need for repeat incision and drainage, intravenous antibiotics, admission, or surgical intervention). The failure rate in adult and pediatric patients is considered secondary outcomes. Results: Seven studies were identified involving 877 patients, with 410 patients in the LDT group, and 467 patients in the CID group. Our meta-analysis process showed a highly significant decrease in the overall failure rate in the LDT group compared to the CID group (p=0.01). Also, we found a non-significant difference in failure rate in adult patients (p>0.05), and a highly significant decrease in failure rate in pediatric patients in the LDT group compared to the CID group (p=0.003). Conclusion: To conclude, the Loop drainage technique for management of skin and soft tissue abscesses is better in a decrease in the overall failure rate (need for repeat incision and drainage, intravenous antibiotics, admission, or surgical intervention) also decrease failure rate in pediatric patients but not significant in decrease failure rate in adult when compared to conventional incision technique.