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Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also regarding your thought processes and the evidence behind your decisions. We can learn from each other!
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July 27, 2019 at 4:59 am
A nice summary of available evidence can be found in Gottlieb M et al: What to do after you cut: recommendations for abscess management in the emergency setting. Ann Emerg Med 2018;71:31-33, an Annals EM and EM:RAP partnership article. The authors’ conclusions are: ultrasonography is useful if the diagnosis is not clinically obvious, small (< 5 cm) abscesses may not need packing but larger abscesses should still be packed pending larger trials, loop drainage is a potential alternative to I&D + packing, consider antibiotics even for uncomplicated abscesses because they lead to a higher cure rate (NNT 7-14).