Incidence of recurrence after radical surgery for perianal abscess

Written by Chen Tian Jing
Colorectal Surgery
Updated on June 15, 2025
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If a perianal abscess is treated with a one-time radical surgery, the recurrence rate is very low. However, it is still necessary for the patient to develop good dietary and bowel habits post-surgery. Since the main cause of perianal abscesses is repeated infection in the anal crypts locally, it is essential to maintain a light diet and regular bowel movements to prevent symptoms of diarrhea.

If chronic diarrhea occurs, it may lead to the retention of infectious materials in the anal crypts, causing repeated infections there. Moreover, if the patient does not maintain a light diet, it might further aggravate the infection, leading to recurrence. If postoperative patients pay attention to a light diet and regular bowel movements, the possibility of recurrence is very low.

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Written by Xiao Zhi Guo
Colorectal Surgery Department
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How to treat perianal abscess?

Perianal abscesses generally have two treatment options. Initially, if the abscess is not very large and the swelling and pain are not particularly severe, conservative treatment with antibiotics can be used temporarily. If conservative treatment is ineffective and the swelling worsens, surgical treatment may be necessary. In cases of severe abscesses, incision and drainage can be considered first, followed by antibiotic treatment. Surgical definitive treatment can then be performed 3-5 days later.

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Written by Chen Tian Jing
Colorectal Surgery
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How to drain pus when a perianal abscess bursts?

If an anal abscess ruptures, it then forms an anal fistula. Both the acute phase of an anal abscess and anal fistula require surgical treatment. If only the local pus is drained, it is generally recommended to open the abscess cavity for local debridement and disinfection, and to further excise the infection focus. During surgery, to protect the function of the local anal sphincter, a seton stitch procedure is also needed. Post-surgery, it is necessary to disinfect and change dressings for the local wound, and ensure normal growth of the granulation tissue to prevent the occurrence of false healing.

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Written by Chen Tian Jing
Colorectal Surgery
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Can a perianal abscess heal by itself?

During the acute phase of a perianal abscess, there is significant local redness, swelling, heat, and pain around the anus. Generally, this condition is caused by an infection of the anal crypts, and the possibility of self-healing is very low, so the main treatment for a perianal abscess is surgery. The surgical approach usually involves incision and drainage of the perianal abscess, combined with a one-time curative surgery. If the abscess ruptures and forms an anal fistula, surgical treatment is also required. During the outbreak of a perianal abscess, due to the severe local pain, it is advisable to undergo surgery as soon as possible to prevent further spread of the abscess. Simple topical medications can only relieve the symptoms of local inflammatory infection and cannot achieve a cure.

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Written by Chen Tian Jing
Colorectal Surgery
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Does a second surgery for a perianal abscess hurt?

When it comes to a second surgery for a perianal abscess, it is generally recommended to proceed directly with spinal anesthesia. Simple local anesthesia might be more painful for the patient, as spinal anesthesia does not cause pain sensations. If there is pain after the surgery, one can opt for oral painkillers or a combination of pain relief pump treatments. Alternatively, pain relief gel can be applied to the wound to alleviate pain before each dressing change. Therefore, after the onset of a perianal abscess, whether it is the first or second surgery, it is essential to operate as soon as possible, and to disinfect and change dressings postoperatively to prevent pseudo-healing or secondary recurrent infections. To relieve pain, painkillers can be chosen. Before or after each bowel movement, one may use clean water for local cleansing to soothe the sphincter and prevent fecal residue.

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Written by Chen Tian Jing
Colorectal Surgery
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Anal abscess should visit which department?

Perianal abscess is a common disease in proctology, generally involving an infection of the local anal crypts and submucosal tissues near the anus. When a perianal abscess acutely flares, it is necessary to register with the department of coloproctology and undergo surgical treatment as soon as possible to prevent the abscess from expanding and leading to a systemic infection. The primary surgical treatment for perianal abscesses is a onetime radical surgery, but when there are changes resembling anal fistulas or leakage, options may also include incision, drainage, and seton procedures. After surgery, it is necessary to disinfect the local wound daily and ensure that the wound drainage is unobstructed.