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.