Title : Routine operative swab cultures for uncomplicated abscesses do they make a difference to the management of patient care?
Abstract:
Introduction: The management of abscesses has long been incision and drainage. Many hospitals still routinely culture the pus intra-operatively and discharge patients with empirical antibiotics.
Method: This retrospective study in a small district general hospital aims to examine whether routine operative swabs of uncomplicated abscesses have an impact on the management and treatment of patients. All patients who were referred to the general surgery team during a three-month period was analysed. The referrals were screened to identify patients who had been diagnosed with a superficial soft tissue abscess and underwent incision and drainage. Body sites that were included in the study included abscesses affecting the axillary wall, breast, abdominal wall, back and perianal regions. Of these abscesses, only ‘uncomplicated’ cases were chosen, and this was defined as patients presenting to surgery with the abscess affecting the region for the first time. Operation notes and lab requests were then reviewed to see whether microscopy, culture, and sensitivity (MC&S) samples were sent. Patient and clinic notes were also reviewed to identify if MC&S sample results were reviewed post-operatively and whether this affected or altered the management of patient care.
Discussion: It argues that routine swabs for uncomplicated abscesses are not cost-effective, has minimal-to-no effect on patient treatment and management, and does not help to reduce the use of antibiotic therapy and should be avoided in these groups of patients.
