Perianal Abscess, Incision and Drainage

Glands near the anus can become blocked. This can lead to infection. If the infection can't drain, a collection of pus called an abscess may form. Symptoms of an abscess include pain, itching, swelling, and fever.

Treatment of this infection has required an incision to drain the pus from the abscess. Many times the drainage is done as an outpatient. More complicated drainage is done in an operating room. A gauze packing may have been put into the abscess opening. Remove this within 1 to 2 days. If it falls out sooner, don't try to put it back in. You may need treatment with antibiotic medicine.

Healing of the wound will take about 1 to 2 weeks, depending on the size of the abscess. As many as half of abscesses will develop anal fistulas that will need treatment.

Home care

  • The wound may drain for the first several days. Cover the wound with a clean dry bandage. Change the dressing if it becomes soaked with blood or pus, or soiled with feces. Use the dressing changing method described by your healthcare provider.

  • If gauze packing was placed inside the abscess cavity, you may be told to remove it yourself. Do this only if the doctor told you to. You may do this in the shower. Once the packing is removed, wash the area carefully once a day until the skin opening has closed. 

  • Try sitz baths. Sit in a tub filled with about 6 inches of hot water for 15 to 30 minutes. Test the water temperature before sitting down to make sure it will not burn you. Repeat this twice a day until pain eases.

  • If you were prescribed antibiotics, take all of the medicine as prescribed. Continue it even if you start feeling better. Finish all of the medicine unless your healthcare provider tells you to stop.

  • Unless a pain medicine has been prescribed, you may take an over-the-counter medicine such as ibuprofen for pain. Talk with your provider about other pain medicine to use if you have a history of ulcers or stomach problems.

  • Passing stools may be painful. If so, ask your healthcare provider about using a stool-softener for a short time.

Follow-up care

Follow up with your healthcare provider, or as advised.

When to seek medical advice

Call your healthcare provider if any of the following occur:

  • Pain, swelling, or redness get worse

  • Pus continuing to drain from the wound 5 days after the incision

  • Fever of 100.4ºF (38ºC) or higher, or as directed by your healthcare provider

  • New symptoms

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