What is the best surgical method for perianal abscess?

A few perianal abscesses can be dissipated by antibiotics, hot water sitz bath, local physical therapy and other methods, but most of them need surgical treatment, and there are two surgical methods.

1, simple abscess can be treated in lithotomy position or lateral position. With local anesthesia or spinal anesthesia, radial incision is made at the abscess site. After pus is discharged, put your hand into your index finger to explore the size of abscess cavity and separate its septum. If necessary, cut the skin at the edge of the incision slightly to facilitate drainage, and finally put vaseline gauze into the abscess cavity for drainage.

2. After the abscess cavity communicates with the anal fistula, the probe can be used to carefully check the internal orifice, then cut the fistula, properly remove the skin and subcutaneous tissue, and slightly remove the tissue around the internal orifice to make the drainage smooth. If the internal orifice is deep and the fistula passes through the anal sphincter, thread-drawing therapy can be used. The advantage of the above operation is that the abscess is cured in one stage and no anal fistula is formed. However, in acute inflammation, when the internal orifice is difficult to find, we can't blindly look for it, so as not to spread the inflammation or form a false channel. We should just cut and drain pus, and then do anal fistula surgery after anal fistula is formed. The advantages of second-stage operation are exact effect and high cure rate.