Management of skin abscesses in the era of methicillin-resistant Staphylococcus aureus

Abscesses are a common form of skin and soft-tissue infection and are increasing in incidence. Although the diagnosis of an abscess can be straightforward, ultrasonography may be helpful in cases in which the abscess is deep, complex, or obscured by extensive cellulitis. A standard approach to incision and drainage remains the mainstay of abscess management, whereas routine packing may be unnecessary. The use of smaller incisions with loop drains and the use of primary closure may be considered in appropriate cases. Adjunctive antibiotic treatment and wound cultures should be limited to patients with severe cases, immunocompromised patients, and those in whom initial therapy is failing. Because of the relatively high failure rates even with optimal treatment, patient education and follow-up are recommended.