Randomized Controlled Trial of a Novel Silicone Device for the Packing of Cutaneous Abscesses in the Emergency Department: A Pilot Study
| Autor: | John Hennessy, Michael J. Twiner, Aaron Brody, Brian Reed, Jerry Marogil, John Z. Gallien |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
silicone device abscess Context (language use) Emergency Nursing Derma-Stent law.invention chemistry.chemical_compound Primary outcome Silicone Standard care Randomized controlled trial law medicine gauze Abscess African american business.industry Emergency department medicine.disease Surgery chemistry Clinical Trial Report Emergency Medicine packing business Open Access Emergency Medicine |
| Zdroj: | Open Access Emergency Medicine : OAEM |
| ISSN: | 1179-1500 |
| Popis: | Aaron Brody,1 John Gallien,1 Brian Reed,1 John Hennessy,2 Michael J Twiner,1,3 Jerry Marogil4 1Department of Emergency Medicine, Wayne State University, Detroit, MI, USA; 2College of Engineering, University of Michigan, Ann Arbor, MI, USA; 3Integrative Biosciences Center, Wayne State University, Detroit, MI, USA; 4Mar-Med Inc, Grand Rapids, MI, USACorrespondence: Michael J TwinerDepartment of Emergency Medicine, 4201 St Antoine, UHC-6G, Detroit, MI, 48201, USATel +1 313-745-3040Email mtwiner@med.wayne.eduObjective: Traditional treatment of abscesses in the emergency department includes packing with gauze; however, this can add pain and discomfort to the procedure and frequently involves a follow-up visit for packing removal. Alternatives to gauze packing have been proposed, but they may have disadvantages in the context of emergency care. The objective of this pilot study was to investigate the use of a novel silicone packing device â the Derma-Stent.Methods: This was a randomized controlled pilot study of 50 patients from two urban emergency departments with uncomplicated superficial abscesses. The primary outcome was the likelihood of self-removal of packing gauze versus the silicone device. Secondary outcome measures included subjective clinician and patient metrics, such as pain and ease of use.Results: Patients identified with simple cutaneous abscesses were randomized to intervention (packing with the novel silicone device, n=25) or standard care (gauze packing, n=25). Mean age was 36 years, 54% were female, and 96% identified as African American. Although it took longer to place, the silicone device (19.0 vs 15.3 minutes, p=0.03), pain scores were significantly lower (4.3/10 vs 7.1/10, p=0.008) and ease of use reported by physicians better in the silicone-device group (4.8/5 vs 4.0/5, p=0.002). A high unknown rate in the gauze-packing group limits discussion of the likelihood of self-removal; however, the silicone device was more likely to remain in place (60%) versus the gauze packing at 3 days (24%, p=0.01).Conclusion: This pilot randomized controlled trial compared the treatment of packing cutaneous abscesses with gauze versus using the silicone device. Limitations in the data prevent discussion on likelihood of self-removal. However, the silicone device was more likely to remain in place at day 3 follow-up and was equally effective to gauze packing in abscess reduction while also improving patient-reported pain scores. It did take longer to place the silicone device; however, physicians reported better ease of use and removal. This pilot study is encouraging for additional larger-scale trials that are required to further assess the utility of this device in the emergency department.Keywords: abscess, Derma-Stent, silicone device, gauze, packing |
| Databáze: | OpenAIRE |
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