Packing versus non-packing for treatment of perianal abscess

Australian researchers have concluded that perianal abscess can be managed safely without continued packing of the cavity, following a comparison of patients with perianal abscess treated either with or without packing of their perianal abscess cavities.

The researchers, from the Flinders Medical Centre in Adelaide, compared 50 patients, of whom 7 were lost to follow-up.

Twenty patients had their perianal abscess cavities treated with packing, while 23 did not have packing used to treat their perianal abscess cavities.

Perianal sepsis is traditionally treated by incision and drainage, with packing of the residual cavity until healing has occurred. The scientists conducted their study to show that perianal abscesses may be safely treated by incision and drainage alone.

Perianal abscesses can be managed safely without continued packing of the cavity

Journal of Gastrointestinal Surgery

The two randomized groups were compared in terms of healing times, analgesic requirements, pain scores, abscess recurrence, and fistula rates.

Both groups were comparable in terms of age and gender distribution, as well as type and size of abscess and the presence of a fistula at operation.

There was no real difference between the 2 groups in mean healing times, rate of abscess recurrence, or post-operative fistula rates.

Pain scores at the first dressing change were also similar between the 2 groups. Although much lower pain scores were recorded in the patients who did not receive packing, this finding did not reach statistical significance.

Commenting on their findings, lead author Darren Tonkin said, "Our pilot study indicates that perianal abscesses can be managed safely without continued packing of the cavity and without any obvious complications."