A pilot randomised controlled trial evaluating postoperative packing of the perianal abscess

Abstract

Within the limitations of a small sample population, the results of this pilot study suggest that not packing the perianal abscess cavity after incision and drainage is safe. Our results show not packing confers less pain with a faster healing time compared with the conventional packing method, and this is a novel finding. These results need to be corroborated in the setting of a larger multicentre randomised controlled trial.

Multicentre observational study of outcomes after drainage of acute perianal abscess

“…Similar recurrence and fistula rates were found in the two groups, suggesting that packing of the abscess cavity is not beneficial. Perera and co‐workers randomized 14 patients and reported shorter healing times in the group without packing ( P = 0·047). Packing may cause patients unnecessary pain without clinical benefit and at increased cost.…”

Value of surgical pilot and feasibility study protocols

“…At a fundamental level, published literature suggests that the wider surgical community may not understand the concept of PFS, with evidence of small, underpowered RCTs often mislabelled as pilot or feasibility studies. Such studies often fail to address baseline feasibility issues such as considering whether a main trial is possible, and instead focus on formal hypothesis testing. Further work is therefore needed to understand when and how PFS may be used optimally to inform future main trials in surgery.…”

Treatment of First-Time Perianal Abscess in Childhood, Balance Recurrence and Fistula Formation Rate with Medical Intervention

“…The choice between conservative treatment and ID is often based on treating physician's personal preference rather than established guidelines. [2][3][4]10,11,14,15 Our protocol for treating perianal abscess consisted of primary conservative and surgical treatment (►Fig. 4).…”

“…In our series, the overall RF rate of 17.5% (82.5% cured) was lower than that of 20 to 85% noted in most series that adopted the ID surgical procedure as the first choice (75% incision). 1,2,[7][8][9]14 In some series, concurrent fistulotomy was adopted for first-time perianal abscess, resulting in recurrence rates ranging from 0 to 9%, but this operation was usually performed with patients under general anesthesia, 2,11 whereas ID required only local anesthesia and can be performed in the outpatient unit.…”