From the Guidelines
A patient with a leg abscess is ready for discharge from inpatient care when they are clinically stable, have had any urgently needed surgery performed, and have achieved acceptable management of their condition, as outlined in the 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections 1. To determine readiness for discharge, several factors should be considered, including:
- Clinical stability, as indicated by resolution of systemic symptoms and improvement in local signs of infection
- Ability to manage their condition independently or with help at the designated discharge location
- A well-defined plan that includes an appropriate antibiotic regimen, wound care instructions, and outpatient follow-up
- Ability to ambulate safely and perform daily activities without significant discomfort or risk of complications Key considerations for discharge planning include:
- Ensuring the patient has a clear understanding of their treatment plan and any necessary follow-up care
- Providing education on warning signs that would necessitate return to care, such as increasing pain, redness, swelling, fever, or purulent drainage
- Arranging for ongoing wound care and management as needed, which may include dressing changes, debridement, or other interventions
- Confirming the patient has access to necessary medications, including antibiotics, pain management, and any other required therapies By prioritizing these factors and ensuring a comprehensive discharge plan is in place, healthcare providers can minimize the risk of readmission and optimize outcomes for patients with leg abscesses, as recommended by the guidelines 1.
From the Research
Discharge Criteria for Patients with Leg Abscess
To determine when a patient with a leg abscess is ready for discharge, several factors should be considered:
- The patient's overall clinical condition and stability
- The size and complexity of the abscess
- The presence of any underlying health conditions that may affect healing
- The patient's ability to manage their condition at home
Management of Leg Abscess
Studies have shown that incision and drainage (I&D) is the standard treatment for abscesses 2, 3, 4. However, the use of antibiotics and wound packing is not always necessary:
- Antibiotics may not improve healing outcomes for uncomplicated abscesses 3, 5
- Wound packing may not be necessary for small abscesses, and may even cause more pain 3
- Loop drainage is a preferred method over traditional I&D 6
Discharge Considerations
Patients can be safely discharged when: