Annika Rühle1,2, Florian Oehme3,4, Jürg Metzger5, Reto Babst3, Björn-Christian Link3, Frank J P Beeres3. 1. Department of General Surgery, Cantonal Hospital Lucerne, Spitalstrasse 16, P.O. Box 6000, 6000, Lucerne, Switzerland. annika.ruehle@med.uni-heidelberg.de. 2. Department of General, Visceral- and Transplantation Surgery, University of Heidelberg, P.O. Box 69120, Heidelberg, Germany. annika.ruehle@med.uni-heidelberg.de. 3. Department of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne, Spitalstrasse 16, P.O. Box 6000, 6000, Lucerne, Switzerland. 4. Department for Visceral, Thoracic and Vascular Surgery, University Hospital Dresden, Carl Gustav Carus University Dresden, P.O. Box 01307, Dresden, Germany. 5. Department of General Surgery, Cantonal Hospital Lucerne, Spitalstrasse 16, P.O. Box 6000, 6000, Lucerne, Switzerland.
Abstract
INTRODUCTION: Skin and soft-tissue infections (SSTI) present regularly as cutaneous abscesses which require surgical drainage. These abscesses often affect younger patients and interfere with their independency substantially. Existing guidelines display heterogeneous recommendations concerning surgical aftercare. Primary aim of this survey was to present a nomogram for standard abscess therapy based on international expert opinions. METHOD: An online survey dealing with standard of care protocols for cutaneous abscesses concerning surgical treatment and aftercare was created. The survey was conducted in 2017 during two international conferences held in Switzerland. RESULT: 490 surgeons originating from 66 nations participated in this survey with the majority coming from Europe and Asia. Indication for surgery, operation type, and wound rinsing were answered homogeneously. Perioperative setting (45% sterile, 55% semi-sterile), anesthesia (45% local, 55% general), antibiotic therapy (38% always, 35% never, 27% other), irrigation fluid (54% sterile, 32% non-sterile, 14% antiseptic), irrigation frequency (55% once daily, 30% twice daily), and wound dressing (69% packing, 31% coverage) were heterogeneously answered topics. CONCLUSION: Treatment and aftercare of simple primary skin abscesses are processed heterogeneously throughout the world. Focus should be on optimal patient focused treatment with minimal socio-economic impact. Future studies should focus on the validation of the different postoperative treatment options with the aim to develop a socio-economically accepted algorithm.
INTRODUCTION: Skin and soft-tissue infections (SSTI) present regularly as cutaneous abscesses which require surgical drainage. These abscesses often affect younger patients and interfere with their independency substantially. Existing guidelines display heterogeneous recommendations concerning surgical aftercare. Primary aim of this survey was to present a nomogram for standard abscess therapy based on international expert opinions. METHOD: An online survey dealing with standard of care protocols for cutaneous abscesses concerning surgical treatment and aftercare was created. The survey was conducted in 2017 during two international conferences held in Switzerland. RESULT: 490 surgeons originating from 66 nations participated in this survey with the majority coming from Europe and Asia. Indication for surgery, operation type, and wound rinsing were answered homogeneously. Perioperative setting (45% sterile, 55% semi-sterile), anesthesia (45% local, 55% general), antibiotic therapy (38% always, 35% never, 27% other), irrigation fluid (54% sterile, 32% non-sterile, 14% antiseptic), irrigation frequency (55% once daily, 30% twice daily), and wound dressing (69% packing, 31% coverage) were heterogeneously answered topics. CONCLUSION: Treatment and aftercare of simple primary skin abscesses are processed heterogeneously throughout the world. Focus should be on optimal patient focused treatment with minimal socio-economic impact. Future studies should focus on the validation of the different postoperative treatment options with the aim to develop a socio-economically accepted algorithm.