i had a perianal abscess operation around 5 weeks back. I have been off antibiotics and the regular dressings for around 10 days. However, I still have pain around that area as well as regular little discharge of pus from the wound. The histopathology report mentioned the following: Nature of Material received: Left perineal abscess wall Gross description: Received a single greyish brown congested irregular ring 1.7 x 1.5 x 1 cm Microscopic description: Biopsy shows fibrosis in skeletal muscle and adipose tissue. One of the fragments shows a sinus tract with a foreign body type granuloma The discharge summary was as follows: Diagnosis Left perianal abscess + Left middle finger abscess Presenting Complaints: Left perianal abscess + Left middle finger abscess incision and drainage Patient had fever since 3-4 days Condition on admission: O/E-GC: T: Afebrile at admission P: 80/min RR: 20/min BP: 120/80 mmHg Pain + S/E: CVS: NAD RS: NAD P/A: NAD Treatment given during hospitalization: Inj. Metrogyl Inj. Formic Inj. Perfalgan Inj. Pantop Inj. Emeset Inj. Tramadol Course of hospitalization: Uneventful Pus c/s (Perianal abscess) E-coli, ESBL producing sensitive to augmentin Investigation reports: Hb: 14.2 WBC: 14700 - (N) 80 Plt: 158 RBS: 95.5 Condition at discharge: O/E-GC: T: Afebrile at admission Pain at operated site P: 89/min BP: 120/80 mmHg S/E: CVS: NAD RS: NAD P/A: NAD Treatment at discharge: Augmentin 625 mg 1-1-1 Zorno 200 mg 1-0-1 Voveron 1-0-1 Pantop 1-0-1

hi bobby,
your perianal abscess surgery would take atleast 2-3 weeks to heal and slowly the soreness and pain will come down day by day as the wound heals.
regular dressings especially after motions is the key to successful healing.
The very fact that your pus c/s report mentions E.coli, I just want to make you aware that these bacteria are from the large intestine. The basic question is from where did the bacteria get into the perianal area??
the answer is that there is a small hole in the anus or rectum on the inner aspect which you have developed. Now everytime you pass stools, some amount of dirt goes in this hole and then the bacteria start growing to form pus. This pus now starts flowing through the path of least resistance and it comes out of the skin of the buttock. Thus a pile-like tunnel has been developed which has an internal opening in the anus and the external opening on the skin of the buttocks.
This is called 'fistula-in-ano'
normally we colorectal surgeons try to find this internal opening at the time of perianal abscess surgery and treat it so the patient does not have a recurrence.
If the internal opening has not been dealth properly at the perianal surgery, then this wound will heal almost completely but a small hole in the skin will not heal.
Once this stage is achieved then you have to undergo a definitive surgery for this Fistula-in-ano.
there are various techniques to cure this fistula by either VAAFT, LIFT or fistula plug technique.
you can find the details on my website pilesfreedom. com.
take care
wish you good health

•  perianal abscess
•  anal fistula plug
•  fistula in ano
•  LIFT