title: Social, economic, and surgical anatomy of a drug-related abscess.
abstract: The "letting of pus" has been a surgical triumph throughout medical history. This study was initiated to expand our knowledge of the etiologic, economic, and surgical aspects of an abscess. The records of 651 patients undergoing intraoperative incision and drainage of an abscess over a 12-month interval were analyzed. The abscesses were due to injection of illicit street drugs in 421 patients (64.7%), perirectal, pilonidal or sweat gland inflammation in 118 patients (18%), complications of diabetes in 22 patients (3.4%) and a prior operative procedure in only 18 patients (2.8%). Fifty-three of the 421 patients with a drug-related abscess were randomly selected for an indepth review. Eighty-three per cent of the patients had positive cultures including 75 per cent with a single organism and 25 per cent with mixed flora. Staphylococcus aureus was present in 62 per cent of the cultures and 41 per cent of the isolates were methicillin resistant. The average length of hospitalization was 12.4 days with a range of 1 to 61 days. The average cost of hospitalization was $10,651 which increased to $24,383 if the patient had a mycotic aneurysm. The estimated annual cost of treatment of this sequela of injected illicit drugs was 6.9 million dollars in our hospital.
mesh_terms: D000038:Abscess / Q000191:economics* / Q000209:etiology / Q000601:surgery; D000328:Adult; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007267:Injections / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D019966:Substance-Related Disorders / Q000150:complications / Q000191:economics*