Internal dressings for healing perianal abscess cavities

There is insufficient evidence of the effectiviness of internal dressings (packing) for the healing of perianal abscess cavities compared with absorbant dressings to cover the area.

Comment: The quality of evidence is downgraded by several shortcomings in study quality and by imprecise results (few patients and wide confidence intervals).

Summary

A Cochrane review included 2 studies with a total of 64 subjects, who were enrolled on the first post-operative day and randomised to continued packing by community district nursing teams or to no packing. Participants in the non-packing group managed their own wounds and used absorbant dressings to cover the area. One study reported a mean time to wound healing of 26.8 days (95% confidence interval (CI) 22.7 to 30.7) in the packing group and 19.5 days (95% CI 13.6 to 25.4) in the non-packing group; 7.30 days longer in the packing group (95% CI -2.24 to 16.84; n=14). The second study reported a median time to complete wound healing of 24.5 days (range 10 to 150 days) in the packing group and 21 days (range 8 to 90 days) in the non-packed group. Between the packed and non-packed groups, there was no clear evidence of a difference in the number of post-operative fistulae detected (RR 2.31, 95% CI 0.56 to 9.45) or in abscess recurrences (RR 0.72, 95% CI 0.22 to 2.37).

Clinical comments

Date of latest search: 17 May 2016

Ədəbiyyat

1. Smith SR, Newton K, Smith JA et al. Internal dressings for healing perianal abscess cavities. Cochrane Database Syst Rev 2016;(8):CD011193.