Postoperative Management with Wound Irrigation in Large Perianal Abscesses: A Case Series Study

術後沖洗傷口用於較大的肛門膿瘍：病例系列報告

林健源(Chien-Yuan Lin) ； 陳禹勳(Yu-Hsun Chen) ； 張敏琪(Min-Chi Chang) ； 王瑞和(Jui-Ho Wang) ； 許詔文(Shao-Wen Hsu) ； 吳志謙(Chih-Chien Wu) ； 李明泓(Ming-Hung Lee)

《中華民國大腸直腸外科醫學會雜誌》 31卷1期 (2020/03) Pp. 26-31

https://doi.org/10.6312/SCRSTW.202003_31(1).10821

摘要

Purpose. The present study aimed to assess the postoperative pain score, abscess recurrence rate, and fistula formation rate in patients with large perianal abscesses after undergoing incision and drainage with wound irrigation. Methods. We retrospectively analyzed patients who underwent incision and drainage with wound irrigation at Kaohsiung Veterans General Hospital between March 2016 and March 2019. We evaluated the abscess recurrence rate, fistula formation rate, postoperative admission duration, and postoperative pain score. Results. Nineteen patients underwent postoperative wound irrigation. The median postoperative admission duration was 7 days (interquartile range 17) (range, 2 to 59 days). The median postoperative day 1 pain score was 3/10 (range, 2/10 to 5/10). The rate of abscess recurrence was 21.1% (4/19) and the fistula formation rate was 15.8% (3/19). Conclusions. Management of perianal abscess using incision and drainage with wound irrigation may decrease postoperative discomfort; it is also relatively easy to care for the patient at their home. Moreover, it provides the benefits of low abscess recurrence and fistula formation rates.

關鍵字

Perianal abscess ； Wound irrigation ； Packing

並列摘要

目的：觀察及追蹤術後沖洗傷口於較大的肛門膿瘍病患之術後疼痛、肛門膿瘍復發機率及肛門瘻管發生機率。材料及方法：我們以回朔性分析之方式，於高雄榮民總醫院收集自2016年3月至2019年3月接受肛門膿瘍切開引流手術及術後沖洗傷口之所有病人。統計資料包括肛門膿瘍復發、新形成肛門瘻管、術後住院天數及術後疼痛評估。結果：共收得19位病人接受術後沖洗傷口照護。術後住院天數中位數為7天（四分位距為17天），住院天數最短為2天，最長為59天。術後第一天自評疼痛分數中位數為3分（滿分10分），術後疼痛最低分為2分，最高分為5分。術後肛門膿瘍復發機率為21.1%（4位病人），新形成肛門瘻管發生機率為15.8%（3位病人）。結論：對於接受引流手術的肛門膿瘍病人，術後沖洗傷口可以減少術後疼痛以及便於居家照顧。另外有較低的肛門膿瘍復發機率及肛門瘻管發生機率。

並列關鍵字

肛門膿瘍 ； 沖洗傷口 ； 紗布填塞

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