TP9.2.6An update of the surgical management of truncal cutaneous abscesses: A systematic scoping review of current practice in 2021

Abstract

Abstract Introduction NHS England has shown efficiency in patient flow and reduction of length of stay resulting in cost savings. There’s considerable variability in local and national guidelines for Incision and drainage (I&D) of cutaneous truncal abscesses which can financially impact NHS expenditure. This Systematic Scoping Review (SSR) aims to explore current management recommendations for I&D of cutaneous truncal abscesses in both adult and paediatric populations; and assess the quality of this research. Method SSR search strategy employed the PICO framework. Cochrane Library, NICE Evidence, Pubmed, OVID medicine, CINAHL and EBSCO databases were searched using search syntax ((“abscess*”OR“perianal abscess*”) AND (“incision and drainage”OR“I&D”) AND (“Equipment*”OR”instrument*”OR“Kit*”OR“theatre staff*”OR“team*”)). Full texts were systematically assessed. Final review performed in accordance with Joanna-Briggs-Institute protocol. Results 131 articles were identified. No limit was placed on publication date. After removal of duplicates and abstract screening, 10 full text articles were assessed. Research suggests day-case emergency surgery pathways to manage I&D of abscesses are efficient and sustainable. Antibiotic use after I&D is weakly recommended and there is low quality evidence for using internal packing for healing perianal abscess cavities, and yet, this is established, common practice. Conclusion There’s variable quality evidence reviewing the surgical pathways for I&D and the post-operative management of cutaneous truncal abscesses. Overall, the findings are limited and further work is required to establish national guidelines.