Emergency department management of skin and soft tissue abscesses

Butson, Ben; Kwa, Paul

doi:10.1111/1742-6723.12464

Cited by 1 publication

(1 citation statement)

References 32 publications

(53 reference statements)

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“…In this US and Australia, cutaneous abscesses are often managed within emergency departments or primary care offices under local anaesthesia, with GA management being only being indicated for complex cases, those with significant co-morbidity, or those who are systemically unwell [ 12 , [17] , [18] , [19] ]. This study suggests that practice in the UK deviates from our international colleagues, with a preference for abscesses requiring I&D to be done under GA. Our results show that size and location are important factors for surgeons when choosing if a cutaneous abscess should be managed through GA or local anaesthetic.…”

Section: Discussionmentioning

confidence: 99%

The surgical management of cutaneous abscesses: A UK cross-sectional survey

Thomas

Ramsay

Yiasemidou

et al. 2020

Annals of Medicine and Surgery

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Aim Cutaneous abscesses are one of the most common acute general surgery presentations. This study aimed to understand the current practice in the management of cutaneous abscesses in the United Kingdom (UK), once the decision has been made that acute surgical incision and drainage (I&D) is required. Method General surgeons from across the UK were surveyed on their opinions on the optimum management of cutaneous abscesses. Outcomes measured included anaesthesia, incision technique, antibiotic administration, departmental abscess pathways, and post-drainage management. A combination of Likert scales, multiple-choice questions, and short answer questions were used. Comparisons were made of Likert scales between regions using a two-sample independent t -test. The survey was peer reviewed and distributed through the Association of Coloproctology of Great Britain and Ireland (ACPGBI) network between April and June 2018. Results Sixty-one responses were collected from surgeons throughout the UK. Of these respondents, 69% indicated that cutaneous abscesses would always or usually require a General Anaesthetic (GA) for treatment, and 82% indicated that abscesses were at least sometimes not treated until the next day due to a lack of resources. While 79% of surgeons stated that pus swabs are always or are usually taken, 44% of respondents never or rarely chased the results. The main indications for giving antibiotics were sepsis/systemically unwell patients, and cellulitis. 31% of responding centres had an abscess management protocol, and 82% of respondents confirmed that they would always pack the abscess wound post-operatively. Conclusion ‘Incision and drainage’ is currently the most widely used technique for the surgical management of cutaneous abscess. However, this study demonstrates the significant variability in the use of anaesthesia, antibiotics, packing and the use of protocols to guide and streamline patient management.

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