SP8.2 Management of Acute Surgical Abscesses (MAGIC): National prospective audit

Abstract

Abstract Aim Subcutaneous abscesses are common, accounting for 2% of all emergency attendances. The aim of this project was to describe the management and outcomes associated with the management of subcutaneous abscesses in surgical practice. Method A national, prospective audit was undertaken. Adult patients presenting to an acute general surgical service with a subcutaneous (non-perianal) abscess between September and December 2022 were included. Data relating to their presentation, management, and outcomes were collected. Outcomes of interest included rates of recurrence, readmission, and complications within 60 days of treatment. A centre-level survey was administered to gather data on clinical resource use and sustainable practices. Results A total of 1247 patients were included across 55 centres. The most common abscess locations were pilonidal (18.8%), posterior thorax (14.5%), and buttock (11.7%). The majority (84.4%) were treated with incision and drainage and half (51.9%) of these also received antibiotics. Surgery was mostly performed with general (65.2%) or local (33.0%) anaesthesia. The rates of recurrence (5.7% vs. 6.7%) and readmission (14.0 vs. 10.3%) were broadly similar, respectively. A quarter (26.6%) of hospitals incorporated dedicated abscess management pathways. The majority of hospitals used single-use items for abscesses drained in ambulatory/ward areas (90.2%) but not in the operating room (13.7%). Conclusions Wide variation exists in the management of subcutaneous abscesses. These data, along with other preparatory work, may justify a trial of general and local anaesthesia in appropriately selected patients.