Reviewing perianal abscess management and recurrence: lessons from a trainee perspective

Area of Science:

• Surgical emergencies
• Colorectal surgery
• Abscess management

Background:

• Perianal abscesses are common surgical emergencies.
• Drainage procedures are frequently delegated to junior surgical trainees.
• Varied trainee experience may impact patient outcomes.

Purpose of the Study:

• To evaluate current perianal abscess management trends.
• To identify factors predicting fistula formation or abscess recurrence.
• To assess the impact of proceduralist experience on outcomes.

Main Methods:

• Retrospective analysis of acute perianal abscess patients over two years.
• Review of patient demographics, clinical, and laboratory findings.
• Analysis of proceduralist experience, management strategy, and recurrence rates.

Main Results:

• Trainees performed 96% of perianal abscess drainage procedures.
• A 31% recurrence rate (fistula or abscess) was observed.
• Inflammatory bowel disease, diabetes, or malignancy significantly increased recurrence risk (P=0.01).

Conclusions:

• Perianal abscess drainage is predominantly performed by trainees, often after hours.
• Fever, IBD, diabetes, or malignancy are risk factors for recurrence.
• Experienced surgeon consultation may improve outcomes, especially for seton insertion or fistulotomy.