From the Guidelines
Treatment for a pinna (auricle) abscess typically involves incision and drainage, and given the location, antibiotic therapy is recommended due to the difficulty in draining the area completely. The first step is incision and drainage of the abscess by a healthcare provider, which allows the pus to be removed 1. This procedure is usually done under local anesthesia. After drainage, the wound may be packed with gauze to keep it open and allow continued drainage.
Key Considerations
- The location of the abscess on the pinna (outer ear) is considered an area difficult to drain completely, which necessitates antibiotic therapy in addition to incision and drainage 1.
- Antibiotic options for empirical coverage of CA-MRSA in outpatients with SSTI include clindamycin, TMP-SMX, a tetracycline (doxycycline or minocycline), and linezolid 1.
- For patients with systemic toxicity or severe cases, intravenous antibiotics might be necessary, with options including vancomycin, linezolid, daptomycin, telavancin, and clindamycin 1.
Management
- Incision and drainage is the primary treatment, with antibiotic therapy recommended due to the location of the abscess.
- Oral antibiotics such as clindamycin (300 mg four times daily) or TMP-SMX (1-2 DS tab PO BID) for 7-10 days can be considered for outpatient treatment 1.
- Pain management with acetaminophen or NSAIDs is also important.
- Warm compresses applied to the area for 15-20 minutes several times daily can help increase blood flow and promote healing.
- Follow-up care is crucial to ensure complete resolution and prevent complications like cartilage damage (chondritis) or spread of infection.
Given the potential for severe complications and the importance of prompt treatment, it is crucial to manage pinna abscesses aggressively, prioritizing both incision and drainage and appropriate antibiotic coverage, as guided by the most recent clinical practice guidelines 1.
From the Research
Treatment for Pinna (Auricle) Abscess
- The treatment for pinna abscess involves surgical drainage, with the goal of removing the purulent material and promoting healing 2.
- Incision and drainage is a common approach, and it is essential to make a surgically appropriate incision that allows adequate drainage without injuring important structures 3.
- A cruciate incision is a novel approach that has been used to treat seroma and hematoma of the pinna, with good outcomes and minimal recurrence 4.
- Prompt surgical management and appropriate antibiotic regimens, including coverage for pseudomonas, are crucial in the treatment of pinna abscesses 2.
- Minimally invasive techniques, such as percutaneous abscess drainage using an indwelling needle cannula, can also be effective in treating abscesses, including those in the head and neck area 5.
- The choice of treatment may depend on the severity of the abscess, the patient's overall health, and the presence of any underlying conditions, such as immunocompromise or systemic signs of infection 6, 3.
Key Considerations
- The management of pinna abscesses requires careful consideration of the potential for complications, such as damage to adjacent structures, bacteremic complications, and misdiagnosis of other conditions 3.
- The use of antibiotics may be necessary in some cases, particularly if there are signs of systemic infection or if the patient has a compromised immune system 6, 2.
- Follow-up care is essential to monitor the patient's progress and to address any potential complications or recurrence of the abscess 4, 2.