1703 The Walking Thread – What Happens to Fistula-In-Ano Patients Who Are Lost to Follow Up? A Service Improvement Study

Abstract Aim 1/3 of idiopathic cryptoglandular abscesses can result in fistula-in-ano. Current practice is to incise and drain primary safety net for patients return as necessary. Known fistula will be appointed Examination Under Anaesthetic at 6-12 weeks.Is this best management or do they become “elective emergencies”? Method We performed a retrospective audit fistula-in-ano over 4 years. used precollected data set Cryptoglandular abscesses, excluding inflammatory, radiation malignant causes collected lost follow up, including presentation, diagnosed first subsequent attendance, number operations, attendances seton placement. Results 512 were operated on abscess causing between 2013 2017. 10% (N = 50) up. 32 had documented up plans, that not fulfilled (eg elective theatre booked). Of these, 18 attendances, 14 emergency. 24 the Seton sited prior being Conclusions The various presentations (emergency, elective, clinic day surgery) long waiting lists mean many these are presenting emergencies still awaiting Many follow-up, with Setons situ. propose fortnightly hot-clinic system, registrar led assess manage patients. This would provide an allow single point access ensuring prompt reduction unnecessary EUA, well improving senior colorectal trainees exposure perianal disease its management.