Ignite Creation Date:
2024-10-26 @ 3:36 PM
Last Modification Date:
2024-10-26 @ 3:36 PM
Study NCT ID:
NCT06527833
Status:
RECRUITING
Last Update Posted:
None
First Post:
2024-07-25
Brief Title:
Procedure-Specific Approach To Minimize Fistulaization of The Perianal Abscess Cavity After Surgical Drainage
Sponsor:
None
Organization:
None
Study Overview
Official Title:
Procedure-Specific Approach To Minimize Fistulaization of The Perianal Abscess Cavity After Surgical Drainage
Status:
RECRUITING
Status Verified Date:
2024-09
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
No
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Perianal abscess is a common surgical condition primarily caused by infection of rectal and anal glandular crypts due to non-specific obstruction Around 10 of cases result from various factors like Crohns disease trauma HIV STDs radiation therapy or foreign bodies Symptoms include perianal pain back pain fever and more The main treatment is incision and drainage but packing during drainage can reduce fistula incidence though it is associated with pain and cost Research comparing outcomes with and without packing is limited
Detailed Description:
Perianal abscess is a common anorectal condition Most perianal abscesses are due to infection of the glandular crypts of the rectum and anus caused by non-specific obstruction A small percentage of cases around 10 can be attributed to alternative causes such as Crohns disease trauma human immunodeficiency virus sexually transmitted diseases radiation therapy or foreign bodies
Perianal abscesses are considered one of the most common colorectal pathologies with an estimated annual incidence of around 20000 people in Egypt Perianal abscesses are more common in males as compared to females and more in younger males than older Also there is an increased risk of anorectal abscess in conditions such as diabetes and obesity
Perianal pain is the most common presentation of perianal abscesses which may increase with defecation movement sitting or coughing Supra-levator abscesses may present with lower back pain or a dull ache in the pelvic region Patients may also report fever malaise rectal drainage erythema of surrounding skin and possibly urinary retention The severity of pain can sometimes prevent the clinician from performing a digital rectal examination or anoscopic examination therefore if the diagnosis is in doubt an examination under general anaesthesia should be performed
Anorectal abscesses can spread into the ischiorectal fossa They can lead to a horse-shoe-shaped collection or track up towards and through the levator musculature making management more challenging Perianal fistulae are a common complication of peri-anal abscesses Fistulae can be classified according to their tract location in relation to the internal and external sphincters as transphincteric fistula high intersphincteric fistula suprasphincteric fistula or extra sphincteric fistula
In the presence of a perianal fistula imaging modalities such as CT scans help diagnose intraabdominal pathology such as Crohns disease and detecting air within the fistulous tract and the abscess cavity However MRI is the investigation of choice in evaluating secondary extensions from the fistulous tract and differentiating it from nearby pelvic soft tissue structures
The management of perianal abscesses is incision and drainage Without adequately eliminating the source of infection antibiotics will be ineffective Minimizing the patients pain protecting anal sphincter function and reducing the recurrence of anal fistulae is as important as curing the abscess Packing at the time of abscess drainage which requires multiple dressing changes per week for several weeks can be helpful in providing hemostasis of the inflamed hypervascular abscess cavity
However about 40 of patients with perianal abscess subsequently develop fistula after management Packing is frequently accompanied by postoperative pain and discomfort slow wound healing and increased financial burden yet lower rate of incidence of fistula as demonstrated in Pearce study Also there is lack of information comparing postoperative outcomes in managing the perianal abscess cavity with packing and with no packing
Perianal abscesses are considered one of the most common colorectal pathologies with an estimated annual incidence of around 20000 people in Egypt Perianal abscesses are more common in males as compared to females and more in younger males than older Also there is an increased risk of anorectal abscess in conditions such as diabetes and obesity
Perianal pain is the most common presentation of perianal abscesses which may increase with defecation movement sitting or coughing Supra-levator abscesses may present with lower back pain or a dull ache in the pelvic region Patients may also report fever malaise rectal drainage erythema of surrounding skin and possibly urinary retention The severity of pain can sometimes prevent the clinician from performing a digital rectal examination or anoscopic examination therefore if the diagnosis is in doubt an examination under general anaesthesia should be performed
Anorectal abscesses can spread into the ischiorectal fossa They can lead to a horse-shoe-shaped collection or track up towards and through the levator musculature making management more challenging Perianal fistulae are a common complication of peri-anal abscesses Fistulae can be classified according to their tract location in relation to the internal and external sphincters as transphincteric fistula high intersphincteric fistula suprasphincteric fistula or extra sphincteric fistula
In the presence of a perianal fistula imaging modalities such as CT scans help diagnose intraabdominal pathology such as Crohns disease and detecting air within the fistulous tract and the abscess cavity However MRI is the investigation of choice in evaluating secondary extensions from the fistulous tract and differentiating it from nearby pelvic soft tissue structures
The management of perianal abscesses is incision and drainage Without adequately eliminating the source of infection antibiotics will be ineffective Minimizing the patients pain protecting anal sphincter function and reducing the recurrence of anal fistulae is as important as curing the abscess Packing at the time of abscess drainage which requires multiple dressing changes per week for several weeks can be helpful in providing hemostasis of the inflamed hypervascular abscess cavity
However about 40 of patients with perianal abscess subsequently develop fistula after management Packing is frequently accompanied by postoperative pain and discomfort slow wound healing and increased financial burden yet lower rate of incidence of fistula as demonstrated in Pearce study Also there is lack of information comparing postoperative outcomes in managing the perianal abscess cavity with packing and with no packing
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None