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Perianal abscess
Anal abscess tight skin tendon pain for a few days
If a perianal abscess undergoes a rubber band ligation surgery, the rubber band may fall off within a week to ten days. If the local rubber band is too loose or takes longer to fall off after surgery, the doctor can further tighten the local rubber band to promote its earlier detachment and ensure the function of the local sphincter around the anus. After tightening the rubber band, the local wound may experience significant pain and minor bleeding due to the pulling of the rubber band. The pain usually lasts about one to two days and will gradually subside as the local wound heals.
Can a perianal abscess heal by itself without rupturing?
Perianal abscesses that have not ruptured generally involve two scenarios. First, the application of topical or oral antibiotics may eliminate the local abscess, but some infection foci and swelling may persist, with a possibility of recurrence later. The second scenario occurs when the abscess does not rupture, but the pus chamber further expands, leading to an increase in the area of infection and thus worsening systemic infection symptoms. Once a perianal abscess is detected, it is necessary to treat it promptly. If an early-stage typical pus chamber has not formed, antibiotics can be used for symptomatic treatment to reduce local inflammation. If a clear pus chamber has formed and is accompanied by pus, it is advisable to promptly perform an incision and drainage of the abscess, followed by a definitive surgical debridement.
Which is more serious, perianal abscess or hemorrhoids?
Perianal abscesses and hemorrhoids are two different types of anorectal diseases. During the acute phase of a perianal abscess, the urgency of the condition is greater than that of hemorrhoids. If active surgical intervention and incisional drainage and debridement are not carried out for a perianal abscess, it can lead to further enlargement of the pus cavity, increasing the size of the infected wound and the focus of infection, causing more severe pain and symptoms of systemic infection in the patient. Hemorrhoids, on the other hand, can be managed with conservative medication to alleviate symptoms. Surgical treatment is considered only when there are recurrent flare-ups, severe pain, significant prolapse, and worsening bleeding.
How to treat recurrent perianal abscess?
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.
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.
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.
Does a recurrent perianal abscess occur in the same location?
The recurrence of a perianal abscess may not necessarily be in the same location, but it is possible. If the internal opening was not completely cleared during the first perianal abscess surgery, this could lead to reinfection of the anal glands and subsequently a recurrence of the perianal abscess. In such cases, it is advisable to visit a hospital early for a perianal MRI to determine the position of the internal opening and the extent of the infected tissue. Then, a one-time radical surgery for the perianal abscess can be performed. After the surgery, it is crucial to consistently use medications like red oil gauze, anal wash, and golden ointment for dressing changes, to promote wound healing and avoid pseudo-healing. Additionally, if a perianal abscess was completely cured once, poor diet, lack of sleep, or frequent alcohol consumption could potentially cause abscesses in other perianal areas later. This situation is quite common, so it is important for patients to maintain a light diet.
How to change dressings for perianal abscess during menstruation?
Dressing changes during menstruation for perianal abscesses require cleansing with warm water after defecation. Sitz baths are not recommended as they may lead to gynecological infections. After thoroughly cleaning the area, it can be wiped with iodine. A hemorrhoid suppository should then be inserted into the anus, and hemorrhoid cream or an anti-inflammatory ointment can be applied to the wound. Covering with a piece of gauze can have an anti-inflammatory and antibacterial effect. Secure it with adhesive tape, and decide the frequency of dressing changes based on the amount of wound excretion. If there is a lot of excretion, it is advised to change the dressing twice a day, in the morning and evening. If the excretion is minimal and there is no feeling of moisture or discomfort, changing the dressing once a day after defecation is sufficient. At the same time, pay attention to a light diet.
Has the perianal abscess that was drained a month ago and is neither painful nor itchy healed?
This situation often shows good post-operative recovery. Whether this situation is completely resolved depends on whether anal fistulas develop later, as most perianal abscesses drained can easily form anal fistulas. This is because drainage of perianal abscesses merely removes pus and secretions as much as possible, but does not completely clear the internal opening of the abscess and infected tissues. Thus, anal fistulas are likely to form later, and the patient needs to continue monitoring. Moreover, it’s important to maintain a light diet, avoiding spicy, irritating, and dry-hot foods as much as possible while also keeping bowel movements smooth. Frequent constipation or diarrhea should be avoided as they can cause wound pain or lead to inflammation and infection of the anal glands, potentially causing recurrence of the perianal abscess or the formation of anal fistulas later. However, the current situation indicates a relatively good post-operative recovery.
How to eliminate a perianal abscess mass?
Perianal abscess nodules are primarily caused by inflammatory infections that lead to local fibrosis, which then forms the nodules. For these nodules, it is recommended to employ a one-time radical cure surgery for perianal abscesses, mainly to remove the internal opening and the inflamed infected tissues. Since a perianal abscess can form a fistula after bursting on its own, failing to completely remove the infected tissue may lead to the development of anal fistulas later. Therefore, clinically, for perianal abscess nodules, it is advised to treat them with a one-time radical cure surgery for perianal abscesses. Post-surgery, medications such as anal washes and red oil ointment gauze strips are chosen for dressing changes. As for early-stage perianal abscess nodules, these are mainly inflammatory infections causing red and swollen lumps, which gradually turn into purulent and liquefied masses. Once suppuration occurs, they can be opened and drained, thereby causing the nodules to disappear. The nodules formed after incision and drainage are mainly considered to be from inflammatory spread to fibrotic tissue, and thus, surgical removal is required in these cases.