How to treat recurrent perianal abscess?

Written by Chen Tian Jing

Colorectal Surgery

Updated on March 09, 2025

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If a perianal abscess has already been treated surgically, it is necessary to develop good dietary and bowel habits postoperatively to reduce the likelihood of recurrence. However, recurrence may still occur due to poor diet and bowel habits of the patient. If there is pain or discomfort at the site of the local wound of the perianal abscess, it is advisable to go to the hospital as soon as possible for an anal examination and perianal ultrasound to confirm if it has recurred. If it is confirmed to have recurred, early surgical treatment is necessary to prevent further expansion of the local infection focus or aggravation of the infection, which would increase the difficulty of treatment later.

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Written by Li Jiao Yan

Neonatology

1min 17sec

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Causes of perianal abscess formation in babies

In pediatric outpatient surgery, perianal abscesses are not uncommon, and many parents visit the hospital daily for this issue. They wait, register, and change dressings. Once the wound heals, it often recurs after a while, leading to repeated incisions and drainage, persisting for several months. Eventually, the doctors say a fistula has formed and surgery is required. What exactly causes such troublesome perianal abscesses? The cause of perianal abscesses is not completely clear, but many affected children have been found to have deeper anal crypts than normal, so it's speculated that it may be related to this abnormality. In children under two years old, perianal abscesses mostly occur in boys. Some studies suggest that testosterone levels are higher in boys aged 1-3 months, coinciding with a peak period for perianal abscess incidences, leading to speculation that it may be related to the child’s hormone levels. In children over two years old, there is less gender bias in the incidence of perianal abscesses, and some cases are secondary to Crohn’s disease.

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Written by Chen Tian Jing

Colorectal Surgery

55sec

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What should I do if the perianal abscess bursts?

Since a perianal abscess is an acute symptom of a local skin infection around the anus, during the acute phase of a perianal abscess, an abscess cavity and pus formation generally occur within about a week. As the disease worsens and progresses, the perianal abscess will rupture about a week later. If the perianal abscess ruptures, it may have already formed an anal fistula. A perianal abscess and an anal fistula represent two different stages of the disease, and both require surgical treatment. The main surgical treatment for anal fistulas is fistulotomy with seton placement, and care must be taken to drain and disinfect the local wound post-surgery to prevent pseudohealing of the wound.

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Written by Chen Tian Jing

Colorectal Surgery

48sec

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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.

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Written by Yu Xu Chao

Colorectal Surgery

1min 8sec

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Can a perianal abscess burst on its own after it forms pus?

After an anal abscess becomes purulent, one should not attempt to rupture it on their own. If purulence occurs, it is advised to perform local disinfection under a doctor's supervision, followed by incision and drainage or pus aspiration to prevent further infection. Attempting to rupture it on your own can easily lead to further aggravation of the local infection. After an anal abscess becomes purulent, the choice of incision location is crucial; once cut, it is necessary to maintain unobstructed drainage to avoid subsequent infection or even necrotizing fasciitis. In clinical practice regarding anal abscesses, it is advised to visit a colorectal surgery department at a hospital as soon as the abscess is detected, to undergo procedures such as incision and drainage or radical surgery of the anal abscess to avoid the later development of anal fistulas or necrotizing fasciitis. Post-surgery, medications such as red oil gauze strips, anal cleansing solutions, and aureomycin ointment are recommended for dressing changes.

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Written by Chen Tian Jing

Colorectal Surgery

53sec

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How to operate on a perianal abscess

The surgical methods for perianal abscess vary depending on the location of the lesion. If it is a simple ischiorectal fossa subcutaneous abscess, a one-time incision and drainage surgery is generally used. The local wound is debrided and necrotic tissue is removed. After trimming the wound, it is important to maintain clear drainage of the local wound. Local application of gauze strips for compression and drainage treatment can be used. If the abscess is in the ischioanal fossa or the pelvirectal space, considering that the location of the lesion is deep, a one-time incision and seton drainage radical surgery may be required for the perianal abscess. Post-surgery, thorough disinfection and drainage of the local wound are also necessary.