Homogenization of the management of acute paronychia with abscess formation within the context of an evaluation of professional practices - 14/07/21

Doi : 10.1016/j.otsr.2021.102982

Valérie Matter-Parrat ^a, Priscille Lazarus ^b, Fiona Goldammer ^b, Marie Bensa ^b, Cécile Ronde-Oustau ^c, Phillipe André Liverneaux ^b, Sybille Facca ^b,⁎
^a Institut Monégasque de Médecine et Chirurgie Sportive (IM2S), 11, Avenue d’Ostende, 98000 Monaco, Monaco
^b Service de chirurgie de la Main, SOS Main, Hôpitaux universitaires de Strasbourg, Icube CNRS 7357, Université de Strasbourg, 1, avenue Molière, 67000 Strasbourg, France
^c Département de chirurgie orthopédique, Unité de Chirurgie septique, Hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67000 Strasbourg, France

^⁎Corresponding author.

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 14 July 2021
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Abstract

Introduction

There is no consensus in the literature, or even within the same team, on the most appropriate treatment option for acute paronychia with abscess formation. The performance of an evaluation of professional practices (EPP) using a clinical audit measures the quality of our practices with the aim of standardizing them. Therefore, the primary objective of this study was to develop a clinical pathway for the management of acute paronychia with abscess formation. The secondary objectives were to evaluate our professional practices using a clinical audit before and after the dissemination of the clinical pathway and then recommend strategies for improving our management of acute paronychia with abscess formation.

Materials and Methods

A working group was established that designed an audit grid comprised of 15 items. Thirty patients (Group 1) who had an acute paronychia with abscess formation were included and their health records were analyzed using this audit grid. The working group then developed a clinical pathway for the management of acute paronychia with abscess formation. Thirty new patients (Group 2) were included after the dissemination of this clinical pathway and their records were analyzed using the same audit grid.

Results

Our clinical pathway for the management of acute paronychia was validated by the local infectious disease committee of our university hospital center. The difference between groups 1 and 2 was significant (p<0.05) for eight items. There was no significant difference in the rate of surgical revision between the two groups.

Discussion

This EPP enabled us to develop a clinical pathway that detailed the processes for managing acute paronychia with abscess formation, and in particular it provided indications for antibiotic therapy and its limitations.