Characteristics of Children Referred for Drainage of Sub-cutaneous Soft Tissue Infections
- 1 Department of Surgery, Division of Pediatric Surgery, University of Kentucky Lexington, Kentucky, USA.
- 2 Department of Surgery, Division of Pediatric Surgery, University of Kentucky Lexington, Kentucky, USA.
- 3 Department of Surgery, Division of Pediatric Surgery, University of Kentucky Lexington, Kentucky, USA.
- 4 Department of Surgery, Division of Pediatric Surgery, University of Kentucky Lexington, Kentucky, USA.
Abstract
Purpose: Severe skin and soft tissue infections in children are a common cause of hospital admission. Surgical drainage is often required for definitive therapy. Our aim was to review common characteristics of children requiring surgical incision and drainage (I&D) for subcutaneous abscesses. Methods: IRB approval was obtained for a retrospective chart review of children requiring I&D of subcutaneous abscesses between July 2006 and June 2011. Data points included patient demographics, abscess location, surgical procedure, microbiology cultures, and hospital length of stay. Results: Surgical I&D were performed on 1042 children, and 781 patients (75%) were admitted to the surgical service. The average age was 3.4 years. 605 patients (58%) were female. 637 abscesses (61%) were located in the groin/but tock/perineum area. Methicillin - resistant Staphylococcus aureus (MRSA) was identified in 70% of the culture specimens. The average length of stay was 2.8 days. The rate of recidivism was 10.9%. Conclusions: Soft tissue infections requiring hospital admission and I&D are common in the pediatric population. The vast majority of these are due to MRSA infections. Infections requiring drainage most frequently occurred in the diaper area of girls less than 3 years old. A significant number of children have recurrent skin infections and represent an important patient subpopulation.
- B. Friedman, T. Berdahl, L. A. Simpson, et al., “Annual Report on Health Care for Children and Youth in the United States: Focus on Trends in Hospital Use and Quality,” Academic Pediatrics, Vol. 11, No. 4, 2011, pp. 263-279. doi:10.1016/j.acap.2011.04.002
- T. Lautz, M. Raval and K. Barsness, “Increasing National Burden of Hospitalizations for Skin and Soft Tissue Infections in Children,” Journal of Pediatric Surgery, Vol. 46, No. 10, 2011, pp. 1935-1941. doi:10.1016/j.jpedsurg.2011.05.008
- Centers for Disease Control, “Four Pediatric Deaths from Community-Acquired Methicillin-Resistant Staphylococcus aureus—Minnesota and North Dakota, 1997-1999,” Journal of the American Medical Association, Vol. 283, No. 12, 1999, pp. 1123-1125.
- C. Frei, B. Makos, K. Daniels, et al., “Emergence of Community-Acquired Methicillin-Resistant Staphylococcus aureus Skin and Soft Tissue Infections as a Common Cause of Hospitalization in United States Children,” Journal of Pediatric Surgery, Vol. 45, No. 10, 2010, pp. 1967-1974. doi:10.1016/j.jpedsurg.2010.05.009
- A. Shapiro, S. Raman, M. Johnson, et al., “CommunityAcquired MRSA Infections in North Carolina Children: Prevalence, Antibiotic Sensitivities, and Risk Factors,” North Carolina Medical Journal, Vol. 70, No. 2, 2009; pp. 102-107.
- A. Pickett, M. Wilkinson, M. Menoch, et al., “Changing Incidence of Methicillin-Resistant Staphylococcus aureus skin Abscesses in a Pediatric Emergency Department,” Pediatric Emergency Care, Vol. 25, No. 12, 2009, pp. 831-834. doi:10.1097/PEC.0b013e3181c06230
- A. McCullough, M. Seifried, X. Zhao, et al., “Higher Incidence of Perineal Community Acquired MRSA Infections among Toddlers,” BMC Pediatrics, Vol. 11, 2011, p. 96. doi:10.1186/1471-2431-11-96
- G. Lina, Y. Piemont, F. Godail-Gamot, et al., “Involvement of Panton-Valentine Leukocidin-Producing Staphylococcus aureus in Primary Skin Infections and Pneumonia,” Clinical Infectious Diseases, Vol. 29, No. 5, 1999; pp. 1128-1132. doi:10.1086/313461
- W. F. McNamara, C. E. Hartin Jr., M. A. Escobar, et al., “An Alternative to Open Incision and Drainage for Community-Acquired Soft Tissue Abscesses in Children,” Journal of Pediatric Surgery, Vol. 46, No. 3, 2011, pp. 502-506. doi:10.1016/j.jpedsurg.2010.08.019
- S. Tsoraides, R. Pearl, A. Stanfill, et al., “Incision and Loop Drainage: A Minimally Invasive Technique for Subcutaneous Abscess Management in Children,” Journal of Pediatric Surgery, Vol. 45, No. 3, 2010, pp. 606609. doi:10.1016/j.jpedsurg.2009.06.013