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. 2020 Mar;90(3):268-271.
doi: 10.1111/ans.15494. Epub 2019 Oct 23.

Fast-track ambulatory abscess pathway: an Australian streamlined emergency surgery pathway

Rafael Gaszynski  1   2 , Andrew Gray  2 , Daniel Leonard Chan  1   2 , Neil Merrett  1   2
Affiliations

Fast-track ambulatory abscess pathway: an Australian streamlined emergency surgery pathway

Rafael Gaszynski et al. ANZ J Surg. 2020 Mar.

Abstract

Background: Superficial skin abscesses account for a significant burden of emergency surgical admissions. The aim of this study was to evaluate the effectiveness of an ambulatory care pathway for emergently treating abscesses of the body requiring operative drainage.

Method: A retrospective study of a prospective patient database was performed, using randomized patient selection. Patient demographics, length and cost of stay were compared between patients undergoing operative management for skin abscess before and after the implementation of the fast-track ambulatory abscess pathway (FAAP).

Results: In total, 100 patients were analysed with 50 in the pre-ambulatory care pathway group and 50 in the FAAP group. The pre-ambulatory care pathway group had a mean age of 37.7 ± 15.8 years versus FAAP group of 35.3 ± 14.5 years. Total length of stay for the group was 85 versus 17 days with a mean comparison of 1.7 days versus 0.34 days (P < 0.001). This translated into a total cost saving of $74 100 in the FAAP group, with a mean comparison cost between the groups of $2884 versus $1402 (P < 0.001). Both reductions in length of stay and cost of stay were statistically significant after implementation of the pathway.

Conclusion: This is the first Australian study to report the findings from an ambulatory care pathway for an emergency surgical intervention. We have shown that skin abscesses presenting through emergency can be managed as a day-case procedure, thereby decreasing these patients' overall length and cost of stay.

Keywords: abscess; ambulatory care; general surgery; perioperative care; soft tissue infection.

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References

    1. Gaszynski R, Punch G, Verschuer K. Loop and drain technique for subcutaneous abscess: a safe minimally invasive procedure in an adult population. ANZ J. Surg. 2018; 88: 87-90.
    1. Stevens DL, Bisno AL, Chambers HF et al. Practice guidelines for the diagnosis and management of skin and soft-tissue infections: 2014 update by the Infectious Diseases Society of America. Clin. Infect. Dis. 2014; 59: e10-52.
    1. Sukumaran V, Senanayake S. Bacterial skin and soft tissue infections. Aust. Prescr. 2016; 29: 159-63.
    1. Vaska VL, Nimmo GR, Jones M, Grimwood K, Paterson DL. Increases in Australian cutaneous abscess hospitalisations: 1999-2008. Eur. J. Clin. Microbiol. Infect. Dis. 2012; 31: 93-6.
    1. Conaghan PJ, Figueira E, Griffin MA, Ingham Clark CL. Randomised clinical trial of the effectiveness of emergency day surgery against standard inpatient treatment. Br. J. Surg. 2002; 89: 423-7.

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