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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Neonatology
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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
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Which department should I go to for perianal abscess?

During the acute phase of a perianal abscess, patients experience significant local redness, swelling, heat, and pain around the anus. The pain is severe and in some cases, patients are unable to sit or walk normally due to the discomfort. During this acute phase, the swelling of the skin around the anus can easily be confused with skin carbuncles, leading patients to mistakenly visit a dermatologist. However, a perianal abscess is a local anal disease that requires registration with a colorectal surgery department, as it is not merely a skin carbuncle but an infection caused by an infection at the anal crypts inside the anal canal. This necessitates prompt surgical incision and drainage, and, if a fistula has formed, a fistulotomy may also be necessary.

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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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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.

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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.