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Q. I had a perianal abscess which was incised three weeks ago, now there is a lump filled with fluid. Why?

Answered by
Dr. Shivpal Saini
and medically reviewed by Dr. Chithranjali Ravichandran
This is a premium question & answer published on May 26, 2021

Hello doctor,

I had a perianal abscess that was incised and drained in the hospital three weeks ago. I have had a small lump next to where they cut ever since, but when I press the lump, this fluid always comes out. I have attached a photo. Is this infection normal? I have no temperature, and I also do not have pain.

#

Hi,

Welcome to icliniq.com.

Treatment of perianal abscess is incision and drainage only.

What the doctor did is the right thing.

Secondly, whenever we do the incision and drainage, the wound generally takes its time to heal completely.

Looking at the pictures you sent (attachments removed to protect the patient's identity), it seems like minimal infective discharge, but it can be normal also if you are not doing any dressing.

I want to know few things-

1. Amount of fluid coming out in 24 hours.

2. Current condition of wound (please attach some current and past photographs of the wound).

3. Whether you doing wound dressing or not?

If you provide me the above information, I will provide you the solution.

I hope this will help.

Hi doctor,

I have sent three pictures of the amount of fluid that comes out of the wound.

Yes, the wound is being dressed with Inadine daily.

#

Hi,

Welcome back to icliniq.com.

Again it depends on the size of the wound. If it is a large wound like 5 to 6 cm, then this amount of discharge is fine, and not to worry at all. But if the wound is completely healed and this discharge is coming out from a pointed sinus, then it is not good. That is why I asked you to send me a clinical photograph of the wound. Anyway, if there is a large wound, then this is completely fine. Keep the wound site clean with soap and water. Apply clean dressing and change it daily. Press the surrounding area to make sure that there is no fluid collection inside the wound.

If possible, please provide a clinical photograph.

I wish you a very speedy recovery.

I hope this will help you.

Let me know if you want anything else.

Hi doctor,

There are two pictures attached.

One is where the cut was, and the other where the redness on the wound is there is where it drains from.

#

Hi,

Welcome back to icliniq.com.

I have both the pictures.

As compared to surgery time, the wound is reduced in size. It is completely healthy-looking, and there is no sign of infection. Just wait for 5 to 7 days. It will heal by itself, and discharge will also stop. Just keep it clean and do clean dressing daily.

Keep patience.

It will heal.

Let me know if you want anything else.

Hi doctor,

So what is that discharge that appears when I press it?

#

Hi,

Welcome back to icliniq.com.

That is discharge from the wound, which is yet to heal.

The wound is healthy and healing, but it is not healed completely.

As soon this wound heals completely, it will stop by itself.

Whenever the raw area in the body, it will give some discharge.

Sometimes fat necrosis at the wound site also comes out as discharge like this.

It will stop when the wound heals.

Wait for 5 to 7 more days.

I hope this will help.

Hi doctor,

Thanks for the reply.

The lump feels like a hardball under the skin this morning. Why is it so?

#

Hi,

Welcome back to icliniq.com.

If discharge from your lump has subsided, then it is healed and nothing to worry about. Pain will also decrease with time (in the next three to five days). But if the discharge is persistent, then it is not a good sign.

Hi doctor,

Thanks for the reply.

I have attached a better picture for your reference. Do you think there is pus in it?

#

Hi,

Welcome back to icliniq.com.

Looking at the recent picture (attachments removed to protect the patient's identity), it seems like there is a small amount of pus inside. But again, you can feel it better, whether that is pus or just a healed scar. To me, it looks like there is a 40 percent chance for a small drop of pus to be present inside and a 60 percent chance for it to be a healed scar. Finally, upon palpating the swelling, if you feel (like very soft and boggy) that there is pus inside, it should be drained. Otherwise, you can wait for two to three days and see whether it is increasing or improving. I would suggest you,

  • Tablet Ciplox TZ (Ciprofloxacin and Tinidazole) one tablet twice daily for five days.
  • Tablet Chymoral Forte (Trypsin-Chymotrypsin) one tablet thrice daily for five days.

The first one is an antibiotic, and the second one is an anti-inflammatory drug. These will help in healing. Thanks.


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