None listed
Conditions
Brief summary
Perianal abscesses are common and important clinical problems. Previous studies have reported that the development of fistula after perianal abscess formation is related to the bacteriology of the abscess and that accurate microbiological analysis of the abscess was very useful in predicting an underlying anal fistula. There was, however, little data concerning the prevention of fistula formation in patients with a perianal abscess without identified fistula.The present study aims to assess if making culture and sensitivity of pus swab and treating the patient with the specific antibiotic following incision and drainage of perianal abscess has any significant impact on surgical outcome in terms of fistula formation.
Interventions
All patients will be operated in Lithotomy position. Anaesthesia whether spinal or general will be determined by the patients and anaesthetist preference and according to patients’s general condition. Examination under anaesthesia will be done first, the area of the abscess will be cleaned with povidone iodine. An alcohol swab will be used to disinfect the area of aspiration. A 10 cm syringe will be used for aspiration of a sample from abscess contents and will be sent for culture and sensitivit
All patients will be operated in Lithotomy position. Anaesthesia whether spinal or general will be determined by the patients and anaesthetist preference and according to patients’s general condition. Examination under anaesthesia will be done first, the area of the abscess will be cleaned with povidone iodine. An alcohol swab will be used to disinfect the area of aspiration. A 10 cm syringe will be used for aspiration of a sample from abscess contents and will be sent for culture and sensitivity study after which abscess will be incised and drained.Patients will be allocated randomly (using closed envelope technique) into two groups: Group A for patients who will receive oral metronidazole (500mg, three times daily TDS for for 3 days , then same antibiotic may be continued for another 4 days or different antibiotic may be given based on results of culture and sensitivity of aspiration sample) as post operative antibiotic. Type of antibiotic will be changed after three days according to the results of the culture and sensitivity of the pus sample taken from the abscess. Patients will be followed up at 1,3,6, and 12 months to detect anal fistula formation.
Sponsors
King Khalid University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
13 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All adult patients complaining of perianal abscess presented to ER department of Aseer Central Hospital and Najran Hospital will be included in this study. Diagnosis of peri anal abscess will be on clinical bases.
Exclusion criteria
*Patients with already formed anal fistula (as the outcome will not be valid) *Patients with pelvi-rectal abscess (as the approach of surgery is different) *Patients with known compromised immune state as DM, malignancy or receiving steroid therapy (as these people require antibiotic coverage to prevent serious complications)
Outcome results
None listed