Perianal fistula: A surgical curse!

Perianal fistula is usually a complication of an inadequately treated perianal abscess. One a perianal abscess is drained, it has to be dressed properly. Special attention has to be given to the deepest portion. It is always observed that the superficial part tends to heal faster as compared to the deeper part. This gives a false sense of security that the wound as a whole is healing well. But the problem starts here. The deeper locule still persists and tends to continue to suppurate.

Pus once formed gives rise to increased tension in the cavity. This tends to point in the direction of least resistance which happens to be two fold that is into the rectum and into the perianal region thus forming a fistula.

So the key to success is to prevent superficial heaing until the deeper portions heal and get filled up with repairative tissue.The process will take at least 21 days. Minimally invasive methods are utterly useless as they fail to address the primary cause as well as defy the laws of natural healing. So also is suture closure of the wound which is again a hopeless way of treating this condition.