Historical Review: Skin and Subcutaneous Abscess Management by Ibn al-Quff in the Islamic Era (1233-1286)

We review abscess management by Ibn al-Quff in the 12 century, described in his book al Omdaa (Arabic version). He explained in detail how an abscess presents, access for drainage, the proper preparation by the surgeon and patient for a procedure, and technical guidelines. It is considered advanced in ensuring the best results of managing this pathology. Much of his advice is already in use, and the rest has either never been considered or has not been studied well. A comprehensive literature review was conducted using PubMed and Google Scholar. Articles were sought about Ibn al-Quff and his contribution to medical knowledge, medical education and quality control for surgical practice. Included were studies of abscess management, options for drainage after maturation, methods of incision and packing after drainage, and preparations to be made by the patient and surgeon for a procedure to be completed correctly. Chapter 10 of the original manuscript of Ibn al-Quff (in Arabic) describes in detail how to manage an abscess, which was compared to current practice. Ibn al-Quff gave clear practice guidelines for abscess management and discussed abscess maturation and the timing of incisions, which are poorly addressed in the current literature. The role of eruptive medicine in helping spontaneous abscess rupture was addressed in the book. The direction of incisions in relation to the location and involvement oforgans for all abscess are not explored in detail. These are considered common sense in the preparation by a surgeon and patients for surgery in modern health care, and they are well explained by Ibn al-Quff. Conclusion: Ibn al-Quff addressed abscess management in an unmatchable manner for his time. Some points that he addressed, like abscess maturation, use of eruptive medicine through local skin applications to help an abscess erupt spontaneously, pus smell in relation to the causative organism, and the direction of incisions based on abscess location, are still areas of active research.