Anatomic and Host Factors Associated with Operative Burden in Hospitalized Patients with Soft-Tissue Abscesses

Background: Operative burden following soft-tissue abscess treatment often depends on anatomic extent, inflammatory burden, and host status. In this study, we evaluated the associations of these factors with additional operation counts and repeat operative source control.Methods: We retrospectively reviewed 44 hospitalized patients who underwent surgical intervention from 2021 to 2025. The primary outcome was additional wound-related operations. A four-covariate Poisson model with HC3 robust standard errors included deep involvement, log2(area), log2(C-reactive protein [CRP]+1), and serum albumin. Repeat drainage/debridement was the secondary outcome; exploratory comparisons underwent false-discovery-rate correction.Results: Fourteen patients (31.8%) had deep involvement. Deep involvement (incidence rate ratio [IRR], 2.67; 95% confidence interval [CI], 1.60–4.46; P<0.001), area per doubling (IRR, 1.24; 95% CI, 1.02–1.51; P=0.031), and albumin per 1-g/dL increase (IRR, 0.61; 95% CI, 0.42–0.89; P=0.009) were associated with additional operations after multivariable adjustment; CRP was not. Repeat source control was required in 13 of the 14 deep involvement cases and 3 of 30 subcutaneous cases. Deep involvement was associated with the number of repeat drainage/debridement procedures (IRR, 6.14; 95% CI, 1.37–27.61; P=0.018). No factor reliably stratified the burden within the deep involvement cases.Conclusion: In this small single-center cohort, anatomic depth, area, and albumin were associated with overall operative burden, and depth was associated with repeat source control. Given the sample size relative to the four-covariate models and the structural linkage between depth and outcomes, these estimates are exploratory and require external validation.