Reviewed on : 1 Jun 2024

Reviewed by : Martin Pratt Trainee Advanced Clinical Practitioner UHCW

Expires : 1 Jun 2026

Anal sepsis

Patients presenting with a peri-anal abscess should be referred using the Surgical Assessment Unit SAU Abscess pathway

See GP Gateway Surgical Assessment Unit

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

Conservative management

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

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