Focused Ultrasound Treatment of Skin and Soft Tissue Abscesses

Skin and soft tissue infections (SSTIs) are among the most common infections encountered in ambulatory and inpatient settings with cellulitis and abscess being most common. Effective treatments are needed as SSTIs are a high-volume condition, and the overall healthcare burden remains high. SSTIs are one of the top causes for hospital readmissions. Furthermore, the standard of care, incision and drainage (I&D), is one of the most painful procedures in the emergency department. In addition to pain and the potential for unsightly scarring, other complications from I&D include damage to surrounding structures, an extension of the infection into adjacent tissues, bacteremic complications and reoccurrence. Furthermore, patient populations with psychosocial risk factors (e.g., homelessness, IV drug use) are prone to secondary infections and wound care remains problematic in these populations. Although bacteria can develop drug resistance, they remain susceptible to mechanical damage. In particular, short intense pulses of Focused Ultrasound (FUS), histotripsy, non-invasively generates localized cavitation that mechanically disrupts the bacteria and represents a new paradigm for non- invasive abscess treatment. We propose that histotripsy can non-invasively disinfect and liquefy many superficial and intramuscular abscesses allowing for complete fine needle aspiration. Our Aims are to expand our animal model to include MRSA pathogens and perform animal studies to advance this technology toward first in human studies. If successful, this approach could decrease patient morbidity, eliminate hospital stays, and lower healthcare costs.