Treatment method selection for perianal abscesses: bedside or operating room? a single center, retrospective study

Area of Science:

• Colorectal Surgery
• Surgical Outcomes
• Perianal Disease Management

Background:

• Perianal abscesses require timely intervention.
• Choosing between bedside and operating room incision and drainage (I&D) impacts outcomes.
• Predictive factors for intervention site selection are needed.

Purpose of the Study:

• To compare clinical outcomes of bedside versus operating room I&D for perianal abscess.
• To identify predictors for selecting the appropriate intervention type.

Main Methods:

• Retrospective analysis of 213 patients with perianal abscess undergoing I&D.
• Comparison of bedside I&D versus operating room I&D groups.
• Receiver operating characteristic (ROC) and logistic regression analyses for predictive factors (WBC, CRP, abscess size).

Main Results:

• Operating room group had higher white blood cell (WBC) counts, C-reactive protein (CRP) levels, and abscess sizes.
• ROC analysis determined cut-off values for WBC (14.68×10⁹/L), CRP (55.7 mg/L), and abscess size (29.5 mm).
• WBC and abscess size were independent predictors for intervention site; fistula development was more frequent after operating room I&D.

Conclusions:

• White blood cell count and abscess size are valuable predictors for perianal abscess intervention.
• Bedside I&D is safe for low-risk patients.
• Operating room intervention is recommended for patients with high inflammatory markers and larger abscesses.