How is the operation of perianal abscess done?

(1) Suction decompression: local disinfection: puncture the abscess cavity from the weakest point with a 20ml syringe, draw out pus, and move the needle up and down while drawing until there is no pus to draw. This method can temporarily reduce the tension of abscess cavity and relieve pain. It is suitable for temporary first aid, but it cannot replace surgery. If the disease develops rapidly, such as necrotizing fasciitis, it cannot be used to avoid delaying the disease.

(2) Incision and drainage: under local anesthesia, a small incision was made from the middle of abscess cavity, and the abscess cavity was washed with metronidazole after operation, and gauze strips were placed for drainage. It belongs to temporary emergency, or the first operation of secondary operation. It can quickly expel pus and relieve symptoms, but it can't replace radical surgery. Generally, it takes about 3 months, and radical surgery is performed after the fistula is formed and the internal orifice is unobstructed.

(3) Radical surgery: early surgical incision and drainage after abscess formation. At present, many scholars have adopted abscess incision, drainage and thread drawing, and achieved good clinical results.

① Low abscess-direct incision. ② horseshoe abscess-incision and pus discharge. ③ Thread-drawing for high abscess. ④ High abscess-isobaric drainage

Because the thread cutting still cut off the anal straight ring, it hurts deeply. In order to further reduce the surgical trauma, bidirectional isobaric drainage can be used, and the abscess cavity can be healed without cutting off the anal straight ring with a semi-tangent line and placing a drainage tube. Postoperative medication and anal nursing were supplemented. Anorectal specialized hospitals generally provide patients with anorectal rehabilitation packages, which include hand-held washcloths that are convenient for patients to wash their anus with water at any time, anal hydrotherapy devices that can be placed on the toilet for bathing, and painless breathable pads that can overhead the painful parts of anal hemorrhoids, so that patients can sit painlessly and promote wound healing.