SP10.14 Comparing packing and non-packing of the abscess cavity post incision and drainage of perianal abscess. A meta-analysis

Abstract

Abstract Aims Wound packing following incision and drainage of perianal abscess has been found to be very painful. The aim of this study is to compare packing the wound and not packing the wound after incision and drainage of perianal abscess. Methods Standard medical electronic databases were searched and relevant published randomised controlled trials (RCT) were shortlisted according to the inclusion criteria. The summated outcome of post-operative pain score, recurrence rate and rate of occurrence of perianal fistula was evaluated using the principles of meta-analysis on RevMan 5 statistical software. Results Three RCTs on 490 patients undergoing incision and drainage of perianal abscess were included. In the random effects model analysis, the post operative pain score was statistically lower in NPG [risk ratio 0.66, 95%, CI (0.36, 0.97), Z=4.25, P=0.0001]. There was no heterogeneity [Tau2 = 0.15; chi2 = 9.32; df = 6; I2 = 36 %; p= 0.16] between the studies, however, statistically it was not significant. In addition, there was no statistical difference between the 2 groups in terms of recurrence of perianal abscess or the occurrence of perianal fistula [risk ratio 0.64, 95%, CI (0.31, 1.31), Z=1.23, P=0.22], [risk ratio 1.41, 95%, CI (0.89, 2.23), Z=1.47, P=0.14] respectively. Conclusion Not packing the wound post incision and drainage of perianal abscess is associated with significantly reduced VAS pain scores and has no effect on recurrence rate or the occurrence of perianal fistula. However, more RCTs recruiting a greater number of patients are required to endorse these findings.