What should be done if there is still pus three months after surgery for perianal abscess in children?

Generally, if there is still pus discharge nearly 3 months after surgery for perianal abscess in children, it may be due to poor wound healing, suture rejection reaction, postoperative wound infection, anal fistula, or wound scar ulceration. Treatment options include general care and medication therapy, as directed by a physician. Detailed explanations are as follows:

1. Poor Wound Healing

Postoperative wounds require a certain amount of time to fully heal. In pediatric patients, especially those with weakened immune function, the healing process may be prolonged, leading to persistent discharge. It is important to keep the perianal area clean and dry, avoid contact with irritants, and attend regular postoperative dressing changes at the hospital to promote wound healing.

2. Suture Rejection Reaction

If non-absorbable sutures were used during surgery, patients with weakened physical condition or decreased immune function may experience a delayed rejection reaction to the sutures, causing symptoms such as local redness, swelling, and pus discharge. Postoperative monitoring of the wound is important, and medical attention should be sought promptly if abnormalities occur. In some cases, removal of the sutures along with wound dressing and disinfection may be necessary.

3. Postoperative Wound Infection

Postoperative wound infection may be associated with bacterial infection. Persistent infection can lead to continuous pus discharge from the wound, accompanied by symptoms such as pain and swelling. Under a physician's guidance, medications such as Cefdinir Dispersible Tablets, Levofloxacin Lactate Capsules, or Levofloxacin Injection may be used for treatment.

4. Anal Fistula

Anal fistula may develop if the perianal abscess was not properly managed, with continuous exudation from the fistulous tract. Pus discharge may persist after surgery, accompanied by perianal dampness and purulent discharge upon palpation. Associated symptoms may include perianal itching. Surgical intervention is usually required, such as fistulotomy or seton placement. Maintaining perianal hygiene and regular wound dressing changes are important after surgery.

5. Wound Scar Ulceration

Wound scar ulceration typically occurs when electrocautery is used during surgery, leading to fat liquefaction and poor wound healing, particularly in individuals with a predisposition to scarring. Symptoms may include recurrent pus discharge, possibly accompanied by pain, swelling, and pigmentation. Treatments may include application of Compound Heparin Sodium Allantoin Gel, Fusidic Acid Sodium Ointment, Erythromycin Ointment, or other medications as directed by a physician.

To prevent these symptoms, it is recommended to regularly clean the perianal area in daily life, keep it dry, and avoid bacterial infection. Engaging in appropriate physical activity can help enhance immunity and promote wound healing. At the same time, strenuous exercise should be avoided to prevent interference with wound healing.