Rationale: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease which usually presents with painful, deep-seated, inflamed lesions in the apocrine gland-bearing areas. Severe HS has interconnecting sinus tracts and when it occurs in the perianal region, perianal fistulas can form. Obesity and smoking are 2 risk factors for the development of HS. Patient concerns: We report a case of a 33-year-old male diagnosed with perianal HS and perianal fistula following a burn injury to the area that occurred during childhood. Diagnosis: Through integration of the clinical signs and imaging results, the patient was diagnosed with HS, Hurley stage III with perianal fistulas. Interventions: The patient accepted surgical therapy. Performed under the general anesthesia, the procedure comprised sinus tracts excision and drainage. Outcomes: The patient was discharged from the hospital 6 weeks after surgery. Lessons: The pathogenesis of the HS in this case was the burn injury interfering with sweat gland formation around the anus. Moreover, the scar from the burn made surgical treatment difficult.

Background: Anal fistula is one of the most common diseases in anorectal surgery. The wound healing after surgery can affect the prognosis of patients. We conducted a protocol for systematic review and meta-analysis to assess the efficacy and safety of Chinese herbal medicine for reducing wound complications after anal fistula surgery. Methods: We have prepared this protocol in accordance with the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA-P) statement. We will search the following databases: the China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Periodical Database, Chinese Biomedical Literature Database, Pubmed, Embase, Web of Science, and the Cochrane library. Two authors will independently assess the risk of bias of the included studies based on the bias risk assessment tool recommended in the Cochrane “Risk of bias” assessment tool. All calculations are carried out with STATA13.0 software. Results: A synthesis of current evidence of Chinese herbal medicine for wound management after anal fistula surgery will be shown in this protocol. Conclusion: This study may provide more convincing evidence to help clinicians make decisions when dealing with anal fistula patients after surgery.