Perianal abscess

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Written by Chen Tian Jing
Colorectal Surgery
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What is the best medicine to take for a perianal abscess?

Perianal abscess is a type of acute infectious disease localized around the anus, and oral medication is not necessarily the best treatment method for perianal abscesses. Rather, the best treatment for perianal abscesses is surgery. Surgical methods generally include incision and drainage procedures, as well as further definitive surgeries, because perianal abscesses are associated with infections in the anal crypts. Thus, medication alone can only relieve symptoms and cannot completely clear the infection. If treatment is solely through medication or if it is incomplete, there is a high likelihood of recurrent infections, which may even lead to the formation of anal fistulas. Once an anal fistula forms, it can only be cured through surgical procedures that involve cutting and threading.

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Written by Chen Tian Jing
Colorectal Surgery
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How many days does the skin around an anal abscess fall off?

During the acute phase of a perianal abscess, if rubber band ligation surgery is performed, the duration of the rubber band falling off generally depends on the location of the lesion. For superficial local perianal abscesses, the rubber band typically falls off within one to ten days. For high-position complex perianal abscesses or those accompanied by anal fistulas, the falling off of the rubber band might take about ten days. In some cases where the rubber band falls off slowly, it may require a doctor's dressing change and assistance to weaken or detach the local rubber band. Do not pull off the rubber band yourself to avoid injuring the local sphincter, which could lead to decreased or abnormal tightness around the anus.

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Written by Chen Tian Jing
Colorectal Surgery
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Is the recurrence rate of perianal abscess high?

Perianal abscess is an acute infectious disease localized around the anus. If a perianal abscess acutely erupts, it requires prompt surgical treatment. Without surgery, there is a possibility of recurrent episodes of perianal abscesses or the formation of anal fistulas due to the rupture of the abscess. After surgery for a perianal abscess, it is also important to pay attention to a light diet and regular bowel movements. It is crucial not to allow the stool to become too dry, nor to experience diarrhea. Recurrent diarrhea can lead to infection of the anal crypts, thereby causing perianal abscesses and local infections. Therefore, the care of a perianal abscess is very important; maintaining good dietary and bowel habits is essential to prevent recurrence of the abscess.

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Written by Xiao Zhi Guo
Colorectal Surgery Department
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How to treat perianal abscess?

Perianal abscesses generally have two treatment options. Initially, if the abscess is not very large and the swelling and pain are not particularly severe, conservative treatment with antibiotics can be used temporarily. If conservative treatment is ineffective and the swelling worsens, surgical treatment may be necessary. In cases of severe abscesses, incision and drainage can be considered first, followed by antibiotic treatment. Surgical definitive treatment can then be performed 3-5 days later.

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Written by Chen Tian Jing
Colorectal Surgery
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Symptoms of perianal abscess

Perianal abscess is a common acute infectious disease in proctology. When a perianal abscess occurs, the patient generally experiences severe pain in the anal area accompanied by local skin redness, increased skin temperature, and even systemic fever and fatigue symptoms due to the local abscess. During an outbreak of a perianal abscess, the abscess cavity or pus encapsulation can generally be clearly seen under perianal color ultrasound, and it is necessary to promptly carry out perianal abscess incision and drainage surgery, as well as further one-time radical surgery for the perianal abscess. If not treated actively, a perianal abscess might rupture and likely form an anal fistula, the treatment of which is also primarily surgical.

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Written by Chen Tian Jing
Colorectal Surgery
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The difference between perianal abscess and anal fistula

Perianal abscesses and anal fistulas both belong to local infectious diseases of the anus. A perianal abscess represents the acute phase of infection, characterized by significant localized subcutaneous swelling, heat, pain, and the formation of pus and abscesses. Once the pus breaks through the skin and discharges, it naturally forms an anal fistula. Anal fistulas represent the later stages or dormant phases of local infections. Both perianal abscesses and anal fistulas require surgical treatment. The surgical method for perianal abscesses mainly involves a one-time radical surgery for the abscess, while the surgical approach for anal fistulas primarily involves fistulotomy with seton placement, followed by regular wound cleaning and dressing changes post-surgery.

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Written by Chen Tian Jing
Colorectal Surgery
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What should I do if there is pus draining from a perianal abscess?

When a perianal abscess occurs, there is typically pus or an enclosed abscess under the skin. If the perianal abscess ruptures and drains pus, it may have developed into an anal fistula. Once a perianal abscess forms an anal fistula, surgical treatment should be carried out as soon as possible. The surgical methods for treating perianal abscesses and anal fistulas mainly include incision drainage debridement surgery and incision with seton placement. After the surgery, due to substantial secretion from the local wound, it is essential to disinfect and change dressings regularly and to monitor the wound daily. It is crucial to prevent excessive granulation or pseudohealing at the local site, which could encapsulate the infection and prevent complete recovery, potentially leading to recurrence in the future.

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Written by Chen Tian Jing
Colorectal Surgery
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Can a perianal abscess be completely cured?

The primary cause of perianal abscesses is the repeated inflammatory stimulation near the dentate line of the anus, leading to infection. As the infection worsens, localized foci of infection form, resulting in the formation of pus and abscesses. Once a perianal abscess has formed, the patient will experience severe pain and will require prompt surgical treatment. If a definitive one-time surgery for the perianal abscess is chosen, it can be completely treated. Post-surgery, simply changing the dressing on the local wound will suffice, and the wound is expected to fully heal and recover. However, if an incision and drainage surgery was performed for the perianal abscess, a fistula may have already formed, requiring a second surgery for cutting and threading the fistula.

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Written by Chen Tian Jing
Colorectal Surgery
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Can a perianal abscess heal by itself?

During the acute phase of a perianal abscess, there is significant local redness, swelling, heat, and pain around the anus. Generally, this condition is caused by an infection of the anal crypts, and the possibility of self-healing is very low, so the main treatment for a perianal abscess is surgery. The surgical approach usually involves incision and drainage of the perianal abscess, combined with a one-time curative surgery. If the abscess ruptures and forms an anal fistula, surgical treatment is also required. During the outbreak of a perianal abscess, due to the severe local pain, it is advisable to undergo surgery as soon as possible to prevent further spread of the abscess. Simple topical medications can only relieve the symptoms of local inflammatory infection and cannot achieve a cure.

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Written by Chen Tian Jing
Colorectal Surgery
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Can an anal abscess be cured by taking medicine?

An anal abscess is formed due to repeated infections within the anal crypts, resulting in localized pus or an encapsulated abscess. During an episode, the patient experiences severe pain, strong positive tenderness, and notable swelling, heat, and pain around the anal area. In severe cases, it can affect normal sitting and even walking activities. When an anal abscess occurs, it generally requires prompt surgical incision and drainage followed by definitive surgery. Relying solely on oral or topical medications cannot completely cure an anal abscess and only serves to alleviate symptoms. Post-surgery for an anal abscess usually involves local dressing changes to prevent pseudohealing and maintain proper drainage of the wound.