International survey evaluating treatment of primary superficial skin abscesses

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.

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.

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.

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.