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Perianal abscess
Does a recurrent perianal abscess occur in the same location?
The recurrence of a perianal abscess may not necessarily be in the same location, but it is possible. If the internal opening was not completely cleared during the first perianal abscess surgery, this could lead to reinfection of the anal glands and subsequently a recurrence of the perianal abscess. In such cases, it is advisable to visit a hospital early for a perianal MRI to determine the position of the internal opening and the extent of the infected tissue. Then, a one-time radical surgery for the perianal abscess can be performed. After the surgery, it is crucial to consistently use medications like red oil gauze, anal wash, and golden ointment for dressing changes, to promote wound healing and avoid pseudo-healing. Additionally, if a perianal abscess was completely cured once, poor diet, lack of sleep, or frequent alcohol consumption could potentially cause abscesses in other perianal areas later. This situation is quite common, so it is important for patients to maintain a light diet.
How to change dressings for perianal abscess during menstruation?
Dressing changes during menstruation for perianal abscesses require cleansing with warm water after defecation. Sitz baths are not recommended as they may lead to gynecological infections. After thoroughly cleaning the area, it can be wiped with iodine. A hemorrhoid suppository should then be inserted into the anus, and hemorrhoid cream or an anti-inflammatory ointment can be applied to the wound. Covering with a piece of gauze can have an anti-inflammatory and antibacterial effect. Secure it with adhesive tape, and decide the frequency of dressing changes based on the amount of wound excretion. If there is a lot of excretion, it is advised to change the dressing twice a day, in the morning and evening. If the excretion is minimal and there is no feeling of moisture or discomfort, changing the dressing once a day after defecation is sufficient. At the same time, pay attention to a light diet.
Has the perianal abscess that was drained a month ago and is neither painful nor itchy healed?
This situation often shows good post-operative recovery. Whether this situation is completely resolved depends on whether anal fistulas develop later, as most perianal abscesses drained can easily form anal fistulas. This is because drainage of perianal abscesses merely removes pus and secretions as much as possible, but does not completely clear the internal opening of the abscess and infected tissues. Thus, anal fistulas are likely to form later, and the patient needs to continue monitoring. Moreover, it’s important to maintain a light diet, avoiding spicy, irritating, and dry-hot foods as much as possible while also keeping bowel movements smooth. Frequent constipation or diarrhea should be avoided as they can cause wound pain or lead to inflammation and infection of the anal glands, potentially causing recurrence of the perianal abscess or the formation of anal fistulas later. However, the current situation indicates a relatively good post-operative recovery.
How to eliminate a perianal abscess mass?
Perianal abscess nodules are primarily caused by inflammatory infections that lead to local fibrosis, which then forms the nodules. For these nodules, it is recommended to employ a one-time radical cure surgery for perianal abscesses, mainly to remove the internal opening and the inflamed infected tissues. Since a perianal abscess can form a fistula after bursting on its own, failing to completely remove the infected tissue may lead to the development of anal fistulas later. Therefore, clinically, for perianal abscess nodules, it is advised to treat them with a one-time radical cure surgery for perianal abscesses. Post-surgery, medications such as anal washes and red oil ointment gauze strips are chosen for dressing changes. As for early-stage perianal abscess nodules, these are mainly inflammatory infections causing red and swollen lumps, which gradually turn into purulent and liquefied masses. Once suppuration occurs, they can be opened and drained, thereby causing the nodules to disappear. The nodules formed after incision and drainage are mainly considered to be from inflammatory spread to fibrotic tissue, and thus, surgical removal is required in these cases.
Does a perianal abscess require hospitalization?
Perianal abscess is a common acute onset disease in proctology. If surgery is performed for a perianal abscess, it is recommended that the patient be hospitalized. Hospitalization observation is mainly for the local wound, to prevent recurrence and infection, and to ensure early proper wound dressing and drainage work, laying a good foundation for granulation growth post-surgery. The general hospitalization duration is about one week to ten days. In some cases, where the symptoms are severe or the abscess cavity is large, the hospital stay may extend to 20 days. During hospitalization, it is necessary for a professional proctologist to disinfect and change dressings of the local wound, and it is important to wash with saline water after each bowel movement.
How to drain pus when a perianal abscess bursts?
If an anal abscess ruptures, it then forms an anal fistula. Both the acute phase of an anal abscess and anal fistula require surgical treatment. If only the local pus is drained, it is generally recommended to open the abscess cavity for local debridement and disinfection, and to further excise the infection focus. During surgery, to protect the function of the local anal sphincter, a seton stitch procedure is also needed. Post-surgery, it is necessary to disinfect and change dressings for the local wound, and ensure normal growth of the granulation tissue to prevent the occurrence of false healing.
Why is a perianal abscess so painful?
During the acute phase of a perianal abscess, the intense pain is mainly due to the formation of an abscess and pus pockets in the subcutaneous area around the anus. The pus within these cavities cannot rupture, causing localized skin nerves to experience pecking-like or jumping pain. The pain from a perianal abscess is generally unbearable for patients, necessitating prompt surgical treatment. The surgical approach for a perianal abscess primarily involves incision and drainage, followed by debridement of the abscess cavity. It is important to note that postoperative disinfection and dressing changes of the local wound are crucial to prevent false healing of the wound.
How many days is the hospital stay for perianal abscess surgery?
After surgery for a perianal abscess, due to the presence of a local wound and the significant discharge from the wound in the early postoperative period, combined with the potential fall of ligatures or elastic bands at the area, a hospital stay of approximately two weeks is required. For severe cases or those with deeper abscess cavities, a hospital stay of three weeks or even a month might be necessary. The main purpose of the hospital stay post-surgery is to monitor for any major bleeding from the wound, and to facilitate dressing changes. Postoperative dressing changes for a perianal abscess wound are crucial for recovery, as only thorough daily disinfection and dressing changes can ensure uniform granulation and growth of local tissues, prevent the enclosure of pus within the local cavity leading to pseudohealing or reinfection, and thus affect the treatment outcome of the surgery. Approximately one month after surgery, regular follow-up visits are required to monitor the healing of the local wound.
If pus is draining from a perianal abscess, does that mean it's getting better?
The discharge of pus from a perianal abscess does not indicate improvement. This situation is due to the spontaneous rupture of the perianal abscess, which can easily lead to the formation of an anal fistula. Since a perianal abscess is caused by an infection of the anal glands and can infect the surrounding tissues, the simple discharge of pus without clearing the internal opening and infected tissues will not resolve the problem. Furthermore, there is a risk of recurrent episodes that may even result in more severe swelling. Therefore, it is necessary to seek early treatment at a hospital's colorectal surgery department for a definitive one-time surgical resolution of the perianal abscess, removing the internal opening and infected tissues. Post-surgery, medications like anal washes and potassium permanganate solutions should be used for dressing changes. Additionally, medications like erythromycin ointment strips and mupirocin ointment can be used to promote healing of the local surgical site. Patients should also maintain perianal hygiene, ensure smooth bowel movements, and avoid dry, hard stools that may irritate and cause pain or bleeding at the wound site.
Perianal abscess clinical manifestations
Perianal abscess is an acute infectious disease of the local skin, mucosa, and sphincter around the anus, characterized by certain acute clinical symptoms, most commonly pain. The onset of a perianal abscess is generally sudden, occurring within one to three days. Due to the formation of a local pus cavity, intense pain is experienced along with the red, swollen, and hot skin in the affected area. The nature of the pain is often throbbing or pecking. If the infection worsens or is not actively treated, it may also cause systemic symptoms such as fever and chills due to the pain and infection. With repeated attacks over a long term, or if the patient's physical condition is poor, further symptoms like fatigue might occur. Acute episodes of perianal abscess require prompt surgical intervention.