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01-09-2004 | Original Contributions

Perianal Abscess: A Pilot Study Comparing Packing With Nonpacking of the Abscess Cavity

Authors: Darren M. Tonkin, M.B.B.S., Elizabeth Murphy, F.R.A.C.S., Mark Brooke-Smith, M.B.B.S., Paul Hollington, F.R.A.C.S., Nicholas Rieger, M.S., Simon Hockley, M.B.B.S., Nigel Richardson, M.B.B.S., David A. Wattchow, Ph.D.

Published in: Diseases of the Colon & Rectum | Issue 9/2004

PURPOSE:

Perianal sepsis is traditionally treated by incision and drainage, with packing of the residual cavity until healing. This study was designed to show that perianal abscess may be safely treated by incision and drainage alone.

METHODS:

Healing times, analgesic requirements, pain scores, abscess recurrence, and fistula rates were compared between two randomized groups treated with and without packing of perianal abscess cavities.

RESULTS:

Fifty patients were recruited (7 lost to follow-up): 20 in the packing and 23 in the nonpacking arm. The groups were comparable in terms of age and gender distribution, type and size of abscess, and the presence of a fistula at operation. Mean healing times were similar (P = 0.214). The rate of abscess recurrence was similar (P = 0.61). Postoperative fistula rates were similar (P = 0.38). Pain scores at the first dressing change were similar (P = 0.296). Although pain scores appeared much reduced in the nonpacking arm, this did not attain statistical significance.

CONCLUSIONS:

Our pilot study indicates that perianal abscesses can be managed safely without continued packing of the cavity without any obvious complications.

Macklin, C, Finan, P 1998Anorectal sepsis, abscess and fistulaSurgery166972

Grace, RH 1990The management of acute anorectal sepsisAnn R Coll Surg Engl721602PubMed

Lockhart-Mummery, JP 1929Discussion on fistula-in-anoProc R Soc Med221331

Marcus, RH, Stine, RJ, Cohen, MA 1995Perirectal abscessAnn Emerg Med25597603PubMed

Ellis, M 1960Incision and primary suture of abscesses in the anal regionProc R Soc Med536524PubMed

Abrahams, N, Doudle, M, Carson, P 1997Open verses closed surgical treatment of abscesses: a controlled clinical trialANZ J Surg671736

Leaper, DJ, Page, RE, Rosenberg, IL, Wilson, DH, Goligher, JC 1976A controlled study comparing the conventional treatment of idiopathic anorectal abscess with that of incision, curettage and primary suture under systemic antibiotic coverDis Colon Rectum194650PubMed

Barnes, SM, Milsom, PL 1988Abscesses: an open and shut case!Arch Emerg Med52005PubMed

Ajao, OG, Ladipo, JK, al-Saigh, AA, Malatani, T 1994Primary closure of breast abscess compared with the conventional gauze packing and daily dressingsW Afr J Med132830

10.

Isbister, WH 1987A simple method for the management of anorectal abscessANZ J Surg577714

11.

Kyle, S, Isbister, WH 1990Management of anorectal abscesses: comparison between traditional incision and packing and de Pezzer catheter drainageANZ J Surg6012931

12.

Eisenhamer, S 1985Emergency fistulectomy of the acute primary anorectal cryptoglandular intermuscular abscess - fistula-in-anoS Afr J Surg2317PubMed

13.

Thomson, JP, Parks, AG 1979Anal abscesses and fistulasBr J Hosp Med2341325

14.

Vasilevsky, CA, Gordon, PH 1984The incidence of recurrent abscesses of fistula-in-ano following anorectal suppurationDis Colon Rectum2712630PubMed

15.

Ramanujam, PS, Prasad, ML, Abcarian, H, Tan, AB 1984Perianal abscesses and fistulas: a study of 1023 patientsDis Colon Rectum275937PubMed

16.

Hebjorn, M, Olsen, O, Haakansson, T, Andersen, B 1987A randomized trial of fistulotomy in perianal abscessScand J Gastroeneterol221746

17.

Schouten, WR, Vroonhoven, TJ 1991Treatment of anorectal abscess with or without primary fistulectomy: results of a prospective randomized trialDis Colon Rectum34603PubMed

18.

Seow-Choen, F, Nicholls, RJ 1992Anal fistulaBr J Surg79197205PubMed

19.

Seow-Choen, F, Leong, AF, Goh, HS 1993Results of a policy of selective immediate fistulotomy for primary anal abscessANZ J Surg634859

20.

Lunniss, PJ, Kamm, MA, Phillips, RK 1994Factors affecting continence after surgery for anal fistulaBr J Surg8113825PubMed

21.

Tang, C-L, Chew, S-P, Seow-Choen, F 1996Prospective randomized trial of drainage alone versus drainage and fistulotomy for acute perianal abscesses with proven internal openingDis Colon Rectum3914157PubMed

Title: Perianal Abscess: A Pilot Study Comparing Packing With Nonpacking of the Abscess Cavity
Authors: Darren M. Tonkin, M.B.B.S.
Elizabeth Murphy, F.R.A.C.S.
Mark Brooke-Smith, M.B.B.S.
Paul Hollington, F.R.A.C.S.
Nicholas Rieger, M.S.
Simon Hockley, M.B.B.S.
Nigel Richardson, M.B.B.S.
David A. Wattchow, Ph.D.
Publication date: 01-09-2004
Publisher: Springer-Verlag
Published in: Diseases of the Colon & Rectum / Issue 9/2004
Print ISSN: 0012-3706
Electronic ISSN: 1530-0358
DOI: https://doi.org/10.1007/s10350-004-0620-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Perianal Abscess: A Pilot Study Comparing Packing With Nonpacking of the Abscess Cavity

PURPOSE:

METHODS:

RESULTS:

CONCLUSIONS:

Keynote webinar | Spotlight on medication adherence

Springer Medicine

PURPOSE:

METHODS:

RESULTS:

CONCLUSIONS:

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