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Audit of management of periorbital cellulitis and abscess in a district general hospital and a tertiary referral centre, in line with published guidelines

Published online by Cambridge University Press:  19 January 2010

N Dhillon ,
N Jones  and
N Fergie
N Dhillon*
Affiliation:
ENT Department, Kings Mill Hospital, Mansfield, UK
N Jones
Affiliation:
ENT Department, Queen's Medical Centre, Nottingham, UK
N Fergie
Affiliation:
ENT Department, Kings Mill Hospital, Mansfield, UK ENT Department, Queen's Medical Centre, Nottingham, UK
*
Address for correspondence: Dr Neeru Dhillon, Peak Stones, 54 Nottingham Road, Ravenshead, Nottingham NG15 9HH, UK. Fax: 01623 464283 E-mail: [email protected]
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Abstract

Objective:

To audit the management of periorbital cellulitis or abscess, in line with guidelines published in 2004, within a district general hospital and a tertiary referral centre.

Method:

Retrospective audit analysing 58 cases at a district general hospital and 61 cases at a tertiary referral centre, encountered since 2004.

Results:

At the tertiary referral centre, 22 patients were diagnosed with pre-septal cellulitis and discharged, as were 20 cases at the district general hospital. At the tertiary referral centre, 95 per cent of patients were correctly seen by an ophthalmologist and 82 per cent by a senior ENT surgeon, compared with 63 and 39 per cent, respectively, at the district general hospital. In both centres, one patient did not receive a computed tomography scan where this was indicated. Despite the need for twice daily monitoring of ophthalmological criteria, both sites lacked 100 per cent compliance. At the tertiary referral centre, 76 per cent of patients were correctly treated with intravenous antibiotics, compared with 68 per cent at the district general hospital.

Conclusion:

At both sites, adherence to guidelines was suboptimal. Management may be improved through improved education and online information support.

Keywords

Orbital CellulitisClinical Audit
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 6 , June 2010 , pp. 636 - 640
Copyright
Copyright © JLO (1984) Limited 2010

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Footnotes

Presented as a poster at the ENT UK Annual Meeting, 11 September 2009, London, UK.

References

1 Jones, NS, Walker, JL, Bassi, S, Jones, T, Punt, J. The intracranial complications of rhinosinusitis: can they be prevented? Laryngoscope 2002;112:59–63CrossRefGoogle ScholarPubMed
2 Howe, L, Jones, NS. Guidelines for the management of periorbital cellulitis/abscess. Clin Otolaryngol 2004;29:725–8CrossRefGoogle ScholarPubMed
3 Starkey, C, Steele, R. Medical management of orbital cellulitis. Pediatr Infect Dis J 2001;20:1002–5CrossRefGoogle ScholarPubMed
4 Arun, JM, Rubin, P. Orbital cellulitis in children. Int Ophthalmol Clin 2001;41:71–86Google Scholar
5 Davis, JP, Stearns, MP. Orbital complications of sinusitis: avoid delays in diagnosis. Postgrad Med J 1994;70:108–10CrossRefGoogle ScholarPubMed
6 Sacks, SH, Lawson, W, Edelstein, D, Green, RP. Surgical treatment of blindness secondary to intraorbital haemorrhage. Arch Otolaryngol Head Neck Surg 1988;114:801–3CrossRefGoogle Scholar
7 Hayreh, SS, Kolder, HE, Weingest, TA. Central retinal artery occlusion and retinal tolerance time. Ophthalmology 1980;87:75–8CrossRefGoogle ScholarPubMed
8 Slavin, M, Glaser, JS. Acute severe irreversible visual loss with sphenoethmoiditis-‘posterior’ orbital cellulitis. Arch Ophthalmol 1987;105:345–8CrossRefGoogle ScholarPubMed