How to drain pus when a perianal abscess bursts?

Written by Chen Tian Jing

Colorectal Surgery

Updated on January 06, 2025

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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 Yu Xu Chao

Colorectal Surgery

1min 6sec

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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.

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Written by Chen Tian Jing

Colorectal Surgery

59sec

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Which department should I go to for perianal abscess?

During the acute phase of a perianal abscess, patients experience significant local redness, swelling, heat, and pain around the anus. The pain is severe and in some cases, patients are unable to sit or walk normally due to the discomfort. During this acute phase, the swelling of the skin around the anus can easily be confused with skin carbuncles, leading patients to mistakenly visit a dermatologist. However, a perianal abscess is a local anal disease that requires registration with a colorectal surgery department, as it is not merely a skin carbuncle but an infection caused by an infection at the anal crypts inside the anal canal. This necessitates prompt surgical incision and drainage, and, if a fistula has formed, a fistulotomy may also be necessary.

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Written by Chen Tian Jing

Colorectal Surgery

1min 4sec

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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 He Cai Dong

Colorectal Surgery Department

1min 5sec

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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.

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Written by Chen Tian Jing

Colorectal Surgery

44sec

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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.