I am going to be frank with you. When it comes to packing an abscess, I absolutely hate it. There is something so barbaric to the idea of shoving a foreign object into someone and telling them to come back in 48 to 72 hours to have it pulled out again.
Patients seem to think the same thing, as their eyes often widen when they are told they are being sent home with something left inside of them. To us in the medical field, this is a relatively normal idea. But to those with no medical background, this idea seems horrible.
In addition, no matter how hard I try, there appears to be no such thing as painless abscess packing in the emergency department (ED). Patients generally tend to hate it.
So is it really necessary? Why do we do it in the first place?
The purported purpose of packing is that it helps absorb any remaining exudate, prevents infection (if it is iodoform) and prevents the incision from prematurely closing, thus allowing the abscess to continue to drain. But in the world of so many medical advances, are we really still at this point?
Surprisingly, the answer is no. As more and more research is performed, it is becoming apparent that our attempts to help abscesses heal faster may actually serve only to be agonizing and fruitless.
In a study published by the Society for Academic Emergency Medicine, two groups were compared after they had their abscesses incised and drained. One group was discharged with packing in place; the other was discharged without packing. The groups were compared and it was found that those in the packing group used a statistically significant amount of more pain medicine including ibuprofen and oxycodone HCl, acetaminophen (Percocet).
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