SRS249 - To swab or not to swab? The utility of pus swabs in surgically drained cutaneous abscesses: a quality improvement project

Abstract Introduction A pus swab specimen can determine the microbiological characteristics of infections and therefore help guide antimicrobial management. The current evidence in their utlity in superfical cutaneous abscesses is limited. Aims Primary AIms: Assess current practice in the use of pus swabs for general surgery patients undergoing incision and drainage of cutaneous abscesses. Methods A retrospective analysis of clinical coded data between 1 January 2023 and 1 January 2024 was performed. Data included location, pus swab use, and if so, were the results reviewed and did they change clinical pratice. A cost analysis was also performed. Results A total of 338 patients were identfied of these, 231 patients were including in the analysis: exclusion was due to lack of data, other speciality, duplication, and coding errors. The most common site of abscesses were: trunk (79), perianal/ischiorectal (58), axilla (28), groin (28), gluteal (11), pilonidal (12) and other (15). A pus swab was sent in 85% (196/231) of cases. 36% (70/196) of results were chased. 4% (3/70) wer used to guide antimicrobial therapy. Of these 4%, two patients had necrotising fasciitis and one had a mesh infection. Out of the 197 swabs taken, over 209 micro-organisms were isolated with an estimated cost of £1733 for the culture and sensitivity testing of these organisms. Conclusions The use of pus swabs generates a significant use of resources and cost with minimal clinical benefit in the use of simple cutaneous abscess in the general surgical patient.