Can a perianal abscess be completely cured?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 07, 2024
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The primary cause of perianal abscesses is the repeated inflammatory stimulation near the dentate line of the anus, leading to infection. As the infection worsens, localized foci of infection form, resulting in the formation of pus and abscesses. Once a perianal abscess has formed, the patient will experience severe pain and will require prompt surgical treatment. If a definitive one-time surgery for the perianal abscess is chosen, it can be completely treated. Post-surgery, simply changing the dressing on the local wound will suffice, and the wound is expected to fully heal and recover. However, if an incision and drainage surgery was performed for the perianal abscess, a fistula may have already formed, requiring a second surgery for cutting and threading the fistula.

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Written by Chen Tian Jing
Colorectal Surgery
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Can an anal abscess be left untreated without surgery?

Surgical treatment is required during the acute phase of a perianal abscess. If surgery is not performed, it could lead to an expansion of the abscess cavity or worsening of the infection. Severe cases may lead to a local cellulitis around the anus, forming an inflammation of the cellular tissue. The surgical approach for a perianal abscess primarily involves incision and drainage, complemented by a one-time radical cure. The surgical principle mainly involves excising the infected local lesions altogether, thoroughly disinfecting and dressing the area, accelerating the shedding of the local infection, and ensuring normal growth of granulation tissue. Postoperative dressing changes are also crucial for the recovery from a perianal abscess.

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Colorectal Surgery
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Does a perianal abscess require hospitalization?

Perianal abscess is a common acute onset disease in proctology. If surgery is performed for a perianal abscess, it is recommended that the patient be hospitalized. Hospitalization observation is mainly for the local wound, to prevent recurrence and infection, and to ensure early proper wound dressing and drainage work, laying a good foundation for granulation growth post-surgery. The general hospitalization duration is about one week to ten days. In some cases, where the symptoms are severe or the abscess cavity is large, the hospital stay may extend to 20 days. During hospitalization, it is necessary for a professional proctologist to disinfect and change dressings of the local wound, and it is important to wash with saline water after each bowel movement.

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Colorectal Surgery
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How many days of antibiotic injections are needed to treat a perianal abscess?

During the acute phase of a perianal abscess, the main focus is on the nature of the local abscess. If it is a hard swelling without pus formation, anti-inflammatory injections or antibiotics can be used for symptomatic treatment. Generally, a five to seven-day course of antibiotic and anti-inflammatory treatment can reduce the local swelling, but it cannot guarantee a 100% chance of non-recurrence in the future. If a local pus cavity or swelling has already formed, and there is pus formation, simply using anti-inflammatory injections for symptomatic treatment will not be curative. Surgery is also required, mainly involving opening the local pus cavity, cleaning out the pus thoroughly, and removing local infection foci to promote normal growth of fresh granulation tissue, which could then lead to the healing of the local wound.

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Colorectal Surgery
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Is the recurrence rate of perianal abscess high?

Perianal abscess is an acute infectious disease localized around the anus. If a perianal abscess acutely erupts, it requires prompt surgical treatment. Without surgery, there is a possibility of recurrent episodes of perianal abscesses or the formation of anal fistulas due to the rupture of the abscess. After surgery for a perianal abscess, it is also important to pay attention to a light diet and regular bowel movements. It is crucial not to allow the stool to become too dry, nor to experience diarrhea. Recurrent diarrhea can lead to infection of the anal crypts, thereby causing perianal abscesses and local infections. Therefore, the care of a perianal abscess is very important; maintaining good dietary and bowel habits is essential to prevent recurrence of the abscess.

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How to deal with a ruptured perianal abscess?

Perianal abscesses that recur or occur acutely may locally form an abscess or pus pocket. If the abscess or pus ruptures, secretions will flow out of the abscess cavity around the anus, further leading to the formation of an anal fistula. After the perianal abscess ruptures, it is necessary to promptly perform local debridement, mainly to thoroughly remove the pus from the abscess cavity and to further disinfect the area. After a typical anal fistula forms, surgical treatment involving a fistulotomy with seton placement is required. The principle of the surgery is to completely remove the local infection while preserving the function of the anal sphincter muscles. Subsequent dressing changes and application of ointments or growth factor gels are necessary to promote normal growth of the granulation tissue.