Use of a Silver-Containing Hydrofiber Dressing for Filling Abscess Cavity Following Incision and Drainage in the Emergency Department: A Randomized Controlled Trial

OBJECTIVE: The objective of this study was to investigate whether the use of a silver-containing hydrofiber dressing to pack abscess cavity after incision and drainage (I & D) leads to faster wound healing and less pain. METHODS: Patients 18 years or older visiting the emergency department with cutaneous abscesses, requiring I & D, were randomly assigned to the intervention (Aquacel Ag; ConvaTec, Skillman, New Jersey) or standard care (iodoform) group between April 2008 and May 2009. Patients were followed up 48 to 72 hours and 10 to 14 days after the initial visit. Primary outcomes were the proportion of patients with greater than 30% reduction in surface area of abscess or cellulitis at first follow-up. RESULTS: Ninety-two patients were enrolled prospectively and randomly assigned to the Aquacel Ag or the iodoform groups; mean age was 38.0 (SD, 12.0) years; 49 patients were in the Aquacel Ag and 43 were in iodoform groups, respectively. There were no differences in demographic and clinical characteristics between groups. Logistic regression analysis showed that the intervention (Aquacel Ag) was independently associated with greater than 30% reduction in surface area of abscess (P = .002) but not in cellulitis at first follow-up. There was also significant decrease in pain intensity perceived by patients in the Aquacel Ag group based on the mean change in Facial Pain Scale scores between the initial visit and first follow-up. CONCLUSION: In patients with cutaneous abscesses, use of an antimicrobial hydrofiber ribbon dressing for packing was associated with faster wound healing and reduction in perceived pain in comparison with use of iodoform dressing.