A controlled study comparing the conventional treatment of idiopathic anorectal abcess with that of incision, curettage and primary suture under systemic antibiotic cover.

The treatment of anorectal abscess by deroofing and packing on an initial inpatient basis has been compared in a controlled trial with that of incision, curettage and primary suture under systemic antibiotic cover in the Accident and Emergency Department. Over a three-year period 219 patients with anorectal abscess were randomly allocated to one or other treatment and subsequently followed up in a rectal clinic. In terms of the time taken for complete healing and the periods lost from work postoperatively, the method of incision, curettage and primary suture under systemic antibiotic cover was found to be significantly superior, without any increased risk of recurrence of the abscess or of subsequent fistula formation.