Patients presenting with a peri-anal abscess should be referred using the Surgical Assessment Unit SAU Abscess pathway.
Patients systemically unwell (fever, hypotension, tachycardia or confusion) should be referred urgently via GP Liaison / A&E to the on call surgeon.
Special caution should be taken with diabetics, patients with Crohn’s disease and patients with compromised immune function.
The wound from an incision and drainage (I&D) should heal within 8 weeks.
Non-healing wounds beyond 8 weeks should be referred to colorectal surgery as an anal fistula.
A short course of antibiotics (with gram negative cover) may stop an abscess from developing but surgical management is needed for established abscesses.
Surgical management comprises drainage of the abscess by needle aspiration and antibiotics but most need drainage (LA or GA).
Post op dressings will be performed in Primary Care by Practice or District nurses.
The wound should be lightly dressed with Aquacel or equivalent dressing material and ‘packing’ tightly is no longer recommended.