Student/Resident Abstracts of the Second International Medical Symposium of El Petén: A Multidisciplinary Approach to Common Medical Problems

Background:Perianal abscesses are the most common anorectal abscesses, yet optimal drainage techniques and postoperative management remain variable.We performed a systematic review to evaluate factors influencing management strategies and recurrence following perianal abscess drainage. Methods:A systematic review was conducted in accordance with PRISMA guidelines.PubMed was searched to evaluate risk factors, imaging modalities, location of incision and drainage (bedside versus operating room), wound packing practices, antibiotic use, fistulotomy, and risk factors for recurrence.The primary outcome was abscess recurrence. Results:Thirteen studies met inclusion criteria.Two large retrospective studies identified diabetes mellitus and increased body mass index as significant risk factors for perianal abscess formation.One large study demonstrated ultrasound to be the most sensitive imaging modality, while computed tomography was the most specific for perianal abscesses.Two retrospective studies showed bedside incision and drainage to be non-inferior to operating room drainage, while a third suggested operative drainage with examination under anesthesia reduced fistula formation.Three systematic reviews and randomized trials demonstrated no reduction in recurrence with routine wound packing.Fistulotomy was associated with decreased recurrence, whereas inflammatory bowel disease and abscess location increased recurrence risk. Conclusion:Bedside incision and drainage is a safe and effective approach for selected patients with perianal abscesses.Routine wound packing does not reduce recurrence, and selective fistulotomy may decrease recurrent disease.Management should be individualized based on patient comorbidities and abscess characteristics.