Perianal abscess surgery: Difference between revisions
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==Overview== | ==Overview== | ||
Treatment of perianal abscesses include examination under [[anesthesia]] (regional or general) as well as [[incision and drainage]] of the pus. [[Antibiotic]]s to cover rectal flora (and not skin flora) should be prescribed perioperatively. | Treatment of perianal abscesses include examination under [[anesthesia]] (regional or general) as well as [[incision and drainage]] of the pus. [[Antibiotic]]s to cover rectal flora (and not skin flora) should be prescribed perioperatively. | ||
==Surgery== | ==Surgery== | ||
Anal abscesses, unfortunately, cannot be treated by a simple course of [[antibiotics]] or other medications. Even small abscesses will need the attention of a surgeon immediately. Treatment is possible in an [[emergency room]] under [[local anesthesia]], but it is highly preferred to be formally admitted to a hospital and to have the surgery performed in an [[operating room]] under [[general anesthesia]]. | Anal abscesses, unfortunately, cannot be treated by a simple course of [[antibiotics]] or other medications. Even small abscesses will need the attention of a surgeon immediately. Treatment is possible in an [[emergency room]] under [[local anesthesia]], but it is highly preferred to be formally admitted to a hospital and to have the surgery performed in an [[operating room]] under [[general anesthesia]]. | ||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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[[Category:Surgery]] | [[Category:Surgery]] | ||
[[Category:Gastroenterology]] | |||
Latest revision as of 23:38, 29 July 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Treatment of perianal abscesses include examination under anesthesia (regional or general) as well as incision and drainage of the pus. Antibiotics to cover rectal flora (and not skin flora) should be prescribed perioperatively.
Surgery
Anal abscesses, unfortunately, cannot be treated by a simple course of antibiotics or other medications. Even small abscesses will need the attention of a surgeon immediately. Treatment is possible in an emergency room under local anesthesia, but it is highly preferred to be formally admitted to a hospital and to have the surgery performed in an operating room under general anesthesia.
Generally speaking, a fairly small but deep incision is performed close to the root of the abscess. The surgeon will allow the abscess to drain its exudate and attempt to discover any other related lesions in the area. This is one of the most basic types of surgery, and is usually performed in less than thirty minutes by the anal surgical team. Generally, a portion of the exudate is sent for microbiological analysis to determine the type of infecting bacteria. The incision is not closed (stitched), as the damaged tissues must heal from the inside toward the skin over a period of time.
The patient is often sent home within twenty-four hours of the surgery, and may be instructed to perform several sitz baths per day, whereby a small basin (which usually fits over a toilet) is filled with warm water (and possibly, salts) and the affected area is soaked for a period of time. Another method of recovery involves the use of surgical packing, which is initially inserted by the surgical team, with redressing generally performed by hospital staff or a District Nurse (however, following the results of several double-blind studies, the effectiveness of surgical packing has come into question). During the week following the surgery, many patients will have some form of antibiotic therapy, along with some form of pain management therapy, consistent with the nature of the abscess.
The patient usually experiences an almost complete relief of the severe pain associated to his/her abscess upon waking from anesthesia; the pain associated with the opening and draining incision during the post-operative period is often mild in comparison.