IJCM  Vol.4 No.7 B , July 2013
Characteristics of Children Referred for Drainage of Sub-cutaneous Soft Tissue Infections
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/buttock/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.

Cite this paper
K. Long, L. Gilligan, K. Cox and J. Draus, "Characteristics of Children Referred for Drainage of Sub-cutaneous Soft Tissue Infections," International Journal of Clinical Medicine, Vol. 4 No. 7, 2013, pp. 24-27. doi: 10.4236/ijcm.2013.47A2006.
[1]   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

[2]   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

[3]   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.

[4]   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

[5]   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.

[6]   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

[7]   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

[8]   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

[9]   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

[10]   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

[11]   A. Ladd, M. Levy and J. Quilty, “Minimally Invasive Technique in Treatment of Complex, Subcutaneous Abscesses in Children,” Journal of Pediatric Surgery, Vol. 45, No. 7, 2010, pp. 1562-1566. doi:10.1016/j.jpedsurg.2010.03.025

[12]   A. Hersh, H. Chambers, J. Maselli, et al., “National Trends in Ambulatory Visits and Antibiotic Prescribing for Skin and Soft Tissue Infections,” Archives of Internal Medicine, Vol. 168, No. 14, 2012, pp. 1585-1591. doi:10.1001/archinte.168.14.1585

[13]   C. Liu, A. Bayer, S. Cosgrove, et al., “Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections in Adults and Children: Executive Summary,” Clinical Infectious Diseases, Vol. 52, No. 3, 2011, pp. 285-292. doi:10.1093/cid/cir034