Multicentre observational study of outcomes after drainage of acute perianal abscess

Abstract

Recurrent abscess is rare and fistula occurs in one-quarter of the patients. Packing is painful and costly.

Perianal abscess

“…29 A recent multicentre observational study of 141 patients from the UK found that packing was costly and dressing changes were associated with a twofold to threefold increase in pain scores. 30 Whichever approach is used, monitor the wound for worsening symptoms, persistent or spreading cellulitis, malaise or pyrexia, and inflammatory markers and discuss with the surgical team in the presence of any of these symptoms.…”

Natural history of anorectal sepsis

“…Anorectal abscesses are common, with 18 000 patients affected each year in England. The condition is treated primarily by incision and drainage in the operating theatre by a general surgeon.…”

Treatment of First-Time Perianal Abscess in Childhood, Balance Recurrence and Fistula Formation Rate with Medical Intervention

“…These abnormal crypts are predisposed to infection and abscess formation, which may be cured, recur, or develop into fistula-in-ano. 1,2,4,6,7 Recurrences and/or development of fistula-in-ano (RF) rates after treatment of perianal abscess are reported in 0 to 85% of cases. This wide range may be due to therapeutic differences (i.e., conservative management vs. surgical intervention) or conventions in reporting and designating fistulas as recurrences or complications.…”

“…This wide range may be due to therapeutic differences (i.e., conservative management vs. surgical intervention) or conventions in reporting and designating fistulas as recurrences or complications. [1][2][3][4][6][7][8][9] Although conservative management is the most frequently used and first-opted approach, surgical intervention, which includes incision and drainage (ID), drainage change alone, or fistulotomy of first-time perianal abscess, may be needed if the conservative treatment cannot control the condition. In fact, the indication for surgical intervention remains obscure and controversial.…”

“…In fact, the indication for surgical intervention remains obscure and controversial. [1][2][3][4][6][7][8][9][10][11] The objective of this retrospective study was to investigate the clinical course and RF rates of first-time perianal abscesses in children < 15 years old, comparing outcomes in the aftermath of conservative management with those after surgical treatment.…”