abscess question

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Regular Member

Date Joined Dec 2006
Total Posts : 149
   Posted 6/19/2008 2:32 PM (GMT -6)   
I had a perianal abscess drained about three weeks ago and I notice a lot of posts talk about packing the incision. Is it strange that mine wasn't packed?
Also, do any of you know how to tell if it's healing-like if I will need further surgery or if it will close on it's own? Thanks in advance!!
Bad flare May '06 resulted in CD diagnosis-symptoms for 10 yrs prior.
Asacol: 2400 mg/day
Now off Prednisone!

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Date Joined Nov 2003
Total Posts : 7056
   Posted 6/19/2008 3:11 PM (GMT -6)   
I think packing it depends on the location and depth of the abscess. Superficial abscesses are not packed but the deeper ones often are. Also, many doctors use seton drains in deep abscesses.
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CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, degenerative disc disease, and a host of other medical problems.

Veteran Member

Date Joined May 2007
Total Posts : 1220
   Posted 6/19/2008 6:20 PM (GMT -6)   

Hi Mj,

I've had several perianal abscesses opened and none were packed.  One was so big and deep -- like an ice cream scoop taken out of me.   sad sad sad    I am still healing from a small one.  It takes several weeks for these to heal completely (the big one took 2 months!).  Patience!  It will get better!  Just make sure you sit in a warm tub several times a day.  I use guaze because I need to cushion my 2 setons and I wet the guaze in sterile saline.  The salt helps keep it clean and promotes healing.  My Doc gave a script for the saline so I get large quantities really cheap!  I also have to watch out for diaper rash -- skin yeast infection.  Patience, patience, and more patience.  And lots of lounging on my side like the Romans did!!  I now think of these healing times as vacations.  Fortunately my job allows me to work from home.

Take care!!

Julia Hill
Veteran Member

Date Joined Mar 2008
Total Posts : 543
   Posted 6/19/2008 7:28 PM (GMT -6)   

How is your surgeon able to find the deeper abscesses all the time? My rectal abscess c/w fistula showed up on MRI, had surgery last Wednesday to drain the abscess but once inside my colorectal surgeon could not find the abscess. He is very experienced, and told me it is like trying to find a needle in a haystack. This is the second time this has happened to me but with two different colorectal surgeons over the years. Any advise, I sure don't want this one to fill up again.

Thank you.

Veteran Member

Date Joined Apr 2005
Total Posts : 2346
   Posted 6/19/2008 7:30 PM (GMT -6)   
I have had a few of mine packed, but it gets taken out the day after surgery, and the other ones I had a mushroom drain put in that was left in for a week-10 days, and then pulled out. It takes a good couple of months for them to heal completely. Soak in the hottest water possible as many times as you can in a day. It helps with the healing. I fold 2 4x4 gauze sponges in half and place them up against the hole to catch the drainage, and then I just change it everytime I use the bathroom. That prevents any irritation from the drainage.

Veteran Member

Date Joined May 2007
Total Posts : 1220
   Posted 6/19/2008 9:06 PM (GMT -6)   
I agree with your advice Chroniemomx2!! I would only add that I jump in the shower after using the toilet and use my hand-held sprayer to clean out the wound.

Julia -- I'm sorry I don't have advice for you. My abscesses have all been easy to feel from the surface. 1 inch to thumb-sized lumps. The big one filled the area from the surface to very deep (up against the vaginal wall). Actually you could just look and see the lump. But mine have all been in the perineum so there isn't as much tissue as other places around the rectum. Sorry you are experiencing such trouble!! Can you feel a lump??

Veteran Member

Date Joined Apr 2005
Total Posts : 2346
   Posted 6/20/2008 6:35 AM (GMT -6)   
Yes, FallColors, I do that also...thanks for adding that! :)

Julia---mine are always deep and have never been able to be seen from the outside, and my surgeon has always found them. I wonder why your surgeon is having trouble.

Have you ever heard of ct guided drainage of abscess? I do NOT recommend it, but I am wondering if the beginning stages of it would work and then he could take you to the OR to finish it the right way. They could do a ct and find the abscess, then drill down to it like they do with when they are doing the ct guided drainage, but stop there, and move you to the OR and have your surgeon drain it and clean it out properly.....just a thought.
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