Precautions for Perianal Abscess

Written by Chen Tian Jing
Colorectal Surgery
Updated on November 09, 2024
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The precautions for perianal abscess mainly include those during an acute episode and post-surgical measures. If it is clearly an acute onset of a perianal abscess, it is important to seek treatment promptly. Treatment methods, besides incision and drainage, further include debridement to achieve a complete cure through surgery. Generally, simple incision and drainage only alleviate temporary pain symptoms. If not followed by definitive surgery, there is a high likelihood of developing anal fistulas, necessitating a second surgery. Post-surgical precautions for a perianal abscess primarily involve maintaining cleanliness of the local wound, changing dressings, and ensuring that the drainage from the wound remains unobstructed to prevent false healing.

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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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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 Yu Xu Chao
Colorectal Surgery
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Can an anal abscess without pus be treated without surgery?

Perianal abscesses require surgical treatment even if there is no pus present, as early-stage perianal abscesses are primarily characterized by pain and noticeable lumps near the anus, with the lumps typically being hard. This condition is mainly considered to be an infection and inflammation of the anal glands, which then infects the surrounding tissue, leading to the development of lumps. Surgical treatment should be undertaken as soon as possible even in the absence of pus, because as the infection worsens over time, it may lead to the formation of pus. Early treatment can be advantageous as the infected area is not very extensive, thus resulting in a smaller surgical wound. For early-stage perianal abscesses, a one-time radical surgery may be chosen to remove the internal opening and the infected tissue thoroughly, followed by postoperative care using medicated substances such as erythromycin ointment gauze, anal washes, or mupirocin ointment to promote healing of the surgical wound.

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Colorectal Surgery
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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.

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Written by Chen Tian Jing
Colorectal Surgery
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Can you drink alcohol with a perianal abscess?

Patients with perianal abscess should not drink alcohol. Long-term or excessive alcohol consumption, due to the effects of evaporation or sublimation, can cause local congestion and edema at the anus, and may also increase the risk of infection. As perianal abscess is a local infectious disease of the anus, not only should alcohol be avoided during the acute phase, but prompt surgical treatment is also necessary. If a patient with a perianal abscess does not undergo timely surgical intervention, the pus cavity may expand and the abscess may further spread and rupture, potentially forming an anal fistula. Excessive drinking could lead to worsened local inflammatory symptoms, resulting in an increase in pus and possibly enhancing pain or infection, leading to a more extensive infection in the anal area. Therefore, patients with a perianal abscess should not consume alcohol.