WP7.12 - The Impact of a ‘Golden Abscess Pathway’ in a Tertiary Teaching Hospital to Optimize Acute Abscess Management

Abstract Introduction The 'Golden Patient' initiative targets operating room efficiency by pre-selecting initial patients, especially beneficial for non-urgent emergencies like abscesses. Anorectal abscesses often face treatment delays due to the prioritization of critical cases. WSES guidelines advocate prompt incision and drainage (I&D) within 24 hours, recommending outpatient management for suitable patients. This study aims to establish an ambulatory 'Golden Abscess Pathway' in a tertiary teaching hospital and assess its impact on acute abscess management efficiency. Patients and Methods This retrospective study at the Leeds Institute of Emergency General Surgery included individuals undergoing I&D for acute abscesses. The pre-pathway cohort spanned 03/01/2023 to 28/04/2023, with the 'Golden Abscess Pathway' implemented on 19/06/2023. The post-pathway cohort covered 19/06/2023 to 16/10/2023. The analysis focused on patient demographics and intervention timelines. Results The study included 199 patients, with 93 pre-pathway (55M: 38F, mean age 34.3 ± 14.5 years) and 106 post-pathway (70M: 36F, mean age 35.4 ± 13.3 years). The 'Golden Abscess Pathway' reduced the average duration from consultation to operation (1.73 days vs. 2.75 days), advanced median operation start time (09:20 vs. 09:47), and decreased overnight stays (34.9% vs. 44.1%). Conclusion Implementation of the 'Golden Abscess Pathway' demonstrated positive outcomes, reducing delays in patient management. These results highlight the pathway's potential to enhance efficiency and overall patient care in acute abscess management.