ThTP3.11 Abscess Incision and Drainage Under Local Anaesthetic: Greener, Faster, Cheaper
Ailsa Innes, Vipin Kammath, Ankita Arora, Oroog Ali, Barry Dent- Surgery
Abstract
Introduction
It is standard practise for incision and drainage (I+D) of abscesses in our general surgery department to be performed under general anaesthetic (GA), despite evidence that local anaesthetic (LA) drainage is safe and effective.
Aims
To evaluate the acceptability and environmental benefits of LA abscess I+D.
Methods
Data were collected for abscesses assessed from January-July 2022. Abscesses that were >5cm, perianal/perineal, on multiple sites, or drained during another procedure were deemed unsuitable for LA. Questionnaires to evaluate patient opinions on sustainability were distributed to 26 patients requiring I+D from November-December 22. Carbon footprints were calculated using published carbon footprint estimates for patient travel and healthcare activity.
Results
130 of the 162 patients seen with abscesses underwent I+D, with 119 done under GA. Of those who had GA I+D, 71 were possibly suitable for LA. Of these 71 patients, 66 were done the following day, requiring admission or the patient to go home and return. The estimated additional carbon footprint of performing these procedures under GA was 1,806kgCO2e. 84% of patients surveyed thought it was ‘important’ or ‘very important’ that their procedure was cost effective, and 57% thought it was ‘important’ or ‘very important’ that their procedure was good for the environment.
Conclusion
Performing suitable abscesses under LA could save 3,096kgCO2e per year: equivalent to driving 19,000km. It would also save money, emergency list space and be more convenient for patients. It is important to many of our patients that their treatments are sustainable.