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Management of Superficial Abscesses: Scope for Day Case Surgery

DOI: 10.1155/2014/308270

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Abstract:

Background. Patients presenting with superficial abscesses are often regarded as low priority and given a less efficient service. Aim. The aim of this study was to investigate the efficiency of emergency treatment of superficial abscesses and to identify areas for service improvement. Method. A retrospective case review of patients admitted to Derriford Hospital, Plymouth, over a four-month period. Results. Ninety-seven patients were included in the study. Seventy two (74%) arrived between 08.00 and 16.00 hours. Overall, 75 patients (77%) were referred on weekdays with 22 patients (23%) during weekends. Seventy-two patients (74%) had treatment under a general anaesthetic. Sixty-three percent of operations occurred within the working day. The time interval between admission and surgery ranged from 52 minutes to 38 hours (mean ± SD 16 ± 9.15). The length of admission ranged from 5.3 hours to 11 days (mean 36 hours). Of the one hundred overnight beds used by the 97 patients, 30 nights were spent awaiting surgery and 70 following surgery and awaiting discharge. Conclusion. Eighty-nine percent of the patients would have been suitable for treatment as day cases. This review shows that a simple service redesign has the potential of reducing inpatient bed occupancy and improving the patient’s journey. 1. Background Abscesses form a significant part of the emergency surgical work in many units. They are generally regarded as lower priority than other surgical emergencies, meaning that the definitive treatment for patients presenting with superficial abscesses is often delayed. This is inconvenient for patients and worsens the sickness absence statistics for employers. There may also be an unnecessary burden on an overstretched health service whilst patients occupy beds awaiting surgery [1]. The aim of this study was to investigate the efficiency of the management of superficial abscesses and identify areas for service improvement such as the provision of a day case abscess service. 2. Patients and Methods This is a retrospective case review of all patients with superficial abscesses admitted to the Surgical Assessment Unit, Derriford Hospital, under the care of general surgeons between July 2011 and November 2011. The list of patients was generated using the hospital coding system. Superficial abscesses included perianal, pilonidal, buttock, chest wall, abdominal wall, back, groin, axillary, upper limb, and lower limb abscesses. There were 2789 patients admitted to the Surgical Assessment Unit (SAU) over the four-month study period. Of the 117 patients

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