Day‐surgery approach for incision and drainage of an abscess

Aim The treatment for an abscess is usually incision and drainage in the emergency theatre. These cases are considered a low priority, and therefore, their procedure is often delayed, resulting in longer inpatient stay. Recent guidelines have recommended a day‐surgery approach for these cases. Patients and Methods An abscess pathway was created to allow patients to go home and return the following morning to be operated first on the emergency list and subsequently discharged by nurses. The process was audited before (retrospectively) and after (prospectively) the introduction of the pathway. It looked at clinically‐well adults presenting with a superficial uncomplicated abscess. Results A total of 40 and 35 patients were included for the preliminary and subsequent audit cycle, respectively. The introduction of the pathway reduced the mean inpatient stay from 29.3 to 13.8 h, reduced the preoperative waiting times from 12.5 to 4.3 h and resulted in only 26 per cent of patients waiting more than 6 h compared with 68 per cent prior to its introduction. Inpatient hospital costs per patient (calculated at £250/bed/day for non‐clinical services) were mean cost to £312.50 and £27.78 per patient, respectively, saving £284.72 per patient. Conclusion The abscess pathway has reduced preoperative waiting times and total inpatient stay significantly, without compromising patient safety.