This study is projected to be a randomised controlled clinical trial (RCCT) to compare two surgical techniques
in the management of carbuncles at Royal Darwin Hospital (RDH), Darwin, Northern Territory. The
epidemiological data on the incidence and prevalence of patients presenting to Territorian Emergency
Department's with Carbuncles are published elsewhere. However, anecdotally, the cases per month requiring
surgical intervention at RDH range between 10 to 20 cases; thus, it is a common surgical presentation to RDH.
The conventional surgical approach is a full thickness excision (saucerisation), which under normal
circumstances results in moderate to large wounds, which often require return to theatre for skin grafting,
result in longer duration of wound healing and length of hospital admission and may jeopardise cosmetic
outcomes. A conservative debridement is a promising approach, which we hypothesise may result in better
and more rapid wound healing, shorter hospital admissions, and better cosmetic outcomes.
Patients will be consented and randomised to either full excision of the carbuncle (the current accepted
approach) or the treatment of incision and drainage and conservative debridement of carbuncle. Post
operatively they will be followed up over a 12-week study period to examine several outcomes of interest. We
intend to use the data from this study to further guide how we approach the surgical management of
carbuncles in the Northern Territory. Based on our secondary outcomes, our RCCT may also hold potential to
reduce length of hospital admissions and return to theatre, and as such may have a financial impact on
RDH.