Comparison of Primary vs Secondary Closure Technique after Incision and Drainage of Cutaneous Abscess

Introduction: Historically, cutaneous abscesses have been managed with incision and drainage (I&D), followed by secondary closure, allowing the wound to heal by secondary intention. However, with the availability of modern antibiotics, the feasibility of primary closure in select cases warrants investigation. This study aimed to evaluate and compare the clinical outcomes of primary versus secondary closure following I&D in patients with cutaneous abscesses. Methods: A cross-sectional study was conducted over one year at a tertiary care center in Central Gujarat, involving 676 patients diagnosed with cutaneous abscesses. Participants were randomly assigned to undergo either primary closure (Group A) or secondary closure (Group B) following I&D. Key outcome measures included healing duration, length of hospitalization, treatment failure, complications, and patient-reported satisfaction using the Visual Analogue Scale (VAS). A p-value of <0.05 was considered statistically significant. Results: Each group consisted of 338 patients. The average healing time in Group A was 8.27 ± 2.23 days, significantly shorter than in Group B. The mean duration of hospital stay for Group A was 2.24 ± 0.87 days, also significantly lower (p<0.001). Group A experienced fewer complications and demonstrated superior cosmetic outcomes compared to Group B, with both differences reaching statistical significance (p<0.001). Conclusions: Primary closure after I&D of cutaneous abscesses resulted in improved clinical outcomes, including faster healing, reduced hospital stay, fewer complications, and enhanced cosmetic appearance, when compared to the conventional secondary closure approach.