Treatment of Abscesses in the Vulva: Conventional Open Treatment Versus Primary Suture Under Antibiotic Cover

Abstract

Seventy patients were treated for a subcutaneous abscess in the vulva. In 35 consecutive patients the abscess was treated conventionally with deroofing of the abscess and wet dressings. In the other 35 consecutive patients the abscess was treated by incision, curettage and primary suture under antibiotic cover with a single dose of clindamycin. In the conventionally treated group the median stay in hospital was 7 days and the median healing time 18 days. In the group treated by primary suture the median stay in hospital was 2 days and the median healing time 7 days (P less than 0.0001). Recurrence of abscess was observed in one patient in each group. No other complications were observed in either group. It is concluded that vulvar abscesses may be treated safely and advantageously by primary suture under antibiotic cover.

Treatment of Bartholin's abscess

“…Positive bacteriological findings in 72% of the patients confirm previous results (2,7,12). Kelly (2) found 55%, Kronborg & Olsen (7) 61 Yo, and Larsen et al (12), 71%.…”

“…Until 1986, marsupialization according to Jacobson (1) was the method of choice at our Department. Ever since Ellis in 19.51 (4) introduced incision, curettage and primary suture of subcutaneous abscesses under antibiotic cover, the method has been used in the treatment of anorectal-, acute pilonidal and subcutaneous abscesses (5)(6)(7)(8)(9)(10)(11)(12)(13)(14).…”

“…Primary suture does not substantially reduce hospitalization, as shown in the study. However, when suturing vulvar abscesses primarily, one can reduce median hospital stay 71% (12).…”