SAQ 316 – Surgery – superficial perianal abscess drainage

Surgery – superficial perianal abscess drainage.

a. Other anatomical types

• Ischiorectal fossa abscess.
• Intersphincteric abscess.
• Supralevator abscess.

b. Drainage approach

• Position the patient in lithotomy, with an assistant if required.
• Prepare and drape the area.
• Make a radial incision into the cavity and take a swab.
• Bluntly dissect the cavity with forceps or a finger.
• Irrigate with normal saline.
• Insert a wick or pack if needed, then clean and dress the wound.

c. Post-procedure care

• Analgesia and constipation prevention.
• Regular dressings; remove the pack on day 1 and do not repack. Sitz baths are optional.
• Close follow-up because fistula-in-ano occurs in around 50%.
• Return precautions for fever, worsening pain, or reaccumulation.