{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:31:46Z","timestamp":1789698706755,"version":"4.0.1"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T00:00:00Z","timestamp":1703203200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute surgical units (ASU) are increasingly being adopted and in our system are staffed by colorectal and non\u2010colorectal general surgeons. This study aims to evaluate whether surgeon specialization was associated with improved outcomes in perianal abscess.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with perianal abscess admitted to the ASU between 2016 and 2020 were identified from a prospective database and their medical records reviewed. Patients with IBD, treatment for fistula\u2010in\u2010ano within the preceding year, or perianal sepsis of non\u2010cryptoglandular origin were excluded. Patients admitted under an ASU colorectal (CR) consultant were compared with those under a non\u2010CR general surgeon in a retrospective cohort study. Primary outcome was perianal abscess recurrence. For those without initial fistula, hazard of recurrent abscess or fistula was analysed. Multivariable Cox PH regression analysis was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four\u2010hundred and eight patients were included (150 CR, 258 non\u2010CR). The CR group more frequently had a fistula identified at index operation (34.0% versus 10.9%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). However, Cox multivariable analysis found no difference in hazard of recurrent abscess between groups (HR 1.12, 95% CI 0.65\u20131.95<jats:italic>, P<\/jats:italic>\u2009=\u20090.681)). Abscess recurred in 18.7% CR and 15.5% non\u2010CR. Subsequent fistula developed in 14.7% in both groups. For patients without initial fistula, there was no difference between groups in hazard of recurrent abscess or fistula (HR 1.18, 95% CI 0.69\u20132.01, <jats:italic>P<\/jats:italic>\u2009=\u20090.539).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Surgeon specialization was not associated with improved outcomes for ASU patients with perianal abscess, albeit with potential selection bias. CR surgeons were more proactive identifying fistulas; this raises the possibility that drainage alone may be adequate treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.18836","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T12:08:35Z","timestamp":1703246915000},"page":"938-944","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Management of acute perianal abscess: is surgeon specialization associated with improved outcomes?"],"prefix":"10.1111","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3817-173X","authenticated-orcid":false,"given":"Gregory A.","family":"Turner","sequence":"first","affiliation":[{"name":"Colorectal Unit, Department of Surgical Specialties Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2866-8841","authenticated-orcid":false,"given":"Nicole","family":"Tham","sequence":"additional","affiliation":[{"name":"Colorectal Unit, Department of Surgical Specialties Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raaj","family":"Chandra","sequence":"additional","affiliation":[{"name":"Colorectal Unit, Department of Surgical Specialties Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6555-7358","authenticated-orcid":false,"given":"David J.","family":"Read","sequence":"additional","affiliation":[{"name":"Colorectal Unit, Department of Surgical Specialties Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Chittleborough","sequence":"additional","affiliation":[{"name":"Colorectal Unit, Department of Surgical Specialties Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob J.","family":"McCormick","sequence":"additional","affiliation":[{"name":"Colorectal Unit, Department of Surgical Specialties Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian P.","family":"Hayes","sequence":"additional","affiliation":[{"name":"Colorectal Unit, Department of Surgical Specialties Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1272819"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000733"},{"key":"e_1_2_7_4_1","first-page":"460","article-title":"Pathogenesis and treatment of fistula\u2010in\u2010ano","volume":"18","author":"Parks AG","year":"1961","journal-title":"Br. Med. J."},{"key":"e_1_2_7_5_1","first-page":"686","article-title":"Outcome after incision and drainage with fistulotomy for ischiorectal abscess","volume":"63","author":"Cox SW","year":"1997","journal-title":"Am. Surg."},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02553848"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02587008"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02553995"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02237048"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e31819a5c52"},{"key":"e_1_2_7_11_1","first-page":"61","article-title":"Incidence and factors influencing the development of fistula\u2010in\u2010ano after incision and drainage of perianal abscesses","volume":"93","author":"Lohsiriwat V","year":"2010","journal-title":"J. Med. Assoc. Thai."},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31821cc1f9"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14464"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-014-2104-7"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006827.pub2"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-021-00384-x"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.12473"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9954"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001180"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2021.106109"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-019-02144-1"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14054"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.18836","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T05:03:50Z","timestamp":1716267830000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.18836"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,22]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/ans.18836"],"URL":"https:\/\/doi.org\/10.1111\/ans.18836","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,22]]},"assertion":[{"value":"2023-10-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}