ThTP8.14 Microbiology pus swab sampling in incision and drainage of abscesses

Abstract

Abstract Background Obtaining microbiology swabs during emergency incision and drainage (I&D) is commonplace for general surgeons. Its necessity is controversial but despite this, abscess swabbing is still routine despite little evidence of follow up of results. Methods All abscess I&D procedures admitted to Surgical Assessment Unit (SAU) at RDH over the period of 3 months from May 2022 to June 2022 were reviewed. Data collection included demographics, admission white cell count (WCC), C-reactive protein (CRP) levels, temperature and co-morbid status as well as any perioperative antibiotic regime. Results 97 patients underwent I&D either under local or general anaesthesia. The most commonly encountered abscess site was perianal (20%) followed by pilonidal (13%). 22% were admitted on antibiotics started elsewhere. 71% had a recorded microbiology swab taken. 59% of microbiology swabs demonstrated no significant growth. 2 swabs (3%) grew MRSA. There was no documented evidence of GP or patient information of this result. 11 patients who were admitted with a temperature of ⩾ 37.5°C (11%); 7 (64%) grew a named organism on pus sampling. 12 patients had a WCC ⩾13 x109/L, and samples were sent in 9. 6 patients grew the following; mixed anaerobes, E.coli, Citrobacter, and Gram positive cocci. Conclusions Microbiology pus sampling for I&D cases is performed ad hoc and results are not routinely chased. For well ambulatory patients I&D can be performed without the need for pus swab sampling at surgeon discretion. If it is performed there should be named clear instruction on follow up of the outstanding results.