Does perianal abscess require secondary surgery?

Perianal abscesses may often require a second surgery, especially if symptoms recur, purulent abscesses are not completely removed, or there is an anal fistula. The specific treatment plan varies depending on the severity of the condition. Generally, drainage is the main method, but in some cases, a second surgery may be required to further alleviate the condition, combined with drug treatment and lifestyle adjustments to promote recovery.

1. Causes of recurrence or incomplete treatment of perianal abscess

Perianal abscess refers to a localized abscess formed after an infection of the perianal soft tissue. If the pus is not completely removed during the first operation or the drainage is insufficient, the infection may recur and a second operation may be required. Improper postoperative care of the patient and secondary infection of the wound will also increase the risk of recurrence; certain primary diseases such as Crohn's disease may also be potential causes.

Solution:

-Reoperation: If the abscess remains or a new focus of infection forms, your doctor may recommend a second incision and drainage to remove the lesion, possibly combined with antibiotic treatment to control the infection.

-Regular debridement: Some patients may need to go to the hospital regularly for wound debridement after surgery to reduce the chance of recurrence of infection.

-Focus on the primary disease: For patients with chronic inflammatory bowel disease (such as Crohn's disease), the primary disease should be evaluated at the same time and the treatment plan should be adjusted.

2. Anal fistula caused by abscess

Perianal abscesses sometimes develop into anal fistulas, which are fistulas formed after the abscesses rupture naturally, and are characterized by continuous oozing of pus. If anal fistulas are confirmed, secondary surgery is necessary, otherwise the condition will continue to worsen and may cause more complicated infection problems.

Recommended surgical options:

-Fistulotomy: Resection of the fistula and preservation of anal function is a common surgical method for the treatment of anal fistula.

- Hanging thread therapy: It is suitable for patients with deep fistula or complex anal fistula. The fistula is gradually removed by hanging thread to protect the sphincter and reduce postoperative complications.

-Basic care: After surgery, the wound area needs to be kept clean, potassium permanganate sitz baths are used to promote recovery, and antibiotics are taken as prescribed by the doctor to prevent bacterial infection.

3. Postoperative lifestyle intervention and prevention of recurrence

In addition to surgery, bad habits in daily life such as sitting for long periods of time, improper diet, constipation or diarrhea may delay the recovery process or cause the abscess to reoccur. Postoperative care and lifestyle adjustments are equally important.

Recommended method:

-Dietary adjustment: Eat more foods rich in dietary fiber (such as whole grains, fruits and vegetables), avoid spicy and irritating foods, and improve the intestinal environment.

-Keep it clean: Clean the anal area every day, especially after defecation, using warm water to avoid abrasions.

-Increase exercise: avoid sitting for long periods of time, and promote blood circulation through moderate physical activity to help wound recovery.

Although perianal abscesses are common, improper treatment may lead to more serious complications. Whether it is the first or second surgery, it is crucial to follow the advice of professional doctors. At the same time, good postoperative care and adjustment of lifestyle habits can reduce the risk of recurrence and improve the quality of life. If the wound is found to be repeatedly suppurated or exuding, a follow-up visit should be made in time to avoid delaying treatment. Health recovery is not a one-day thing, and adherence to scientific treatment and careful care is the key.