Mayo stand and back table instruments for Perianal Abscess surgery setup

Clamping & Occluding

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  Curved Hemostat

Cutting & Dissecting

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  #3 Knife Handle

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  Metzenbaum Scissor

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  Straight Mayo Scissor

Grasping & Holding

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  Debakey Forcep

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  Adson Forceps

Suctioning

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  Yankauer Suction

Suturing & Stapling

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  Mayo-Hegar Needle Holder

What to expect during Perianal Abscess

A perianal abscess surgery is a procedure performed to drain a collection of pus that has formed in the tissues around the anus. The surgery involves making an incision in the abscess, draining the pus, and irrigating the area. The abscess may be sutured closed or a penrose drain may be inserted to facilitate further drainage. The surgery is typically performed under sedation or general anesthesia and may involve positioning the patient in lithotomy or prone position.

Position
Lithotomy, or prone, and they may only be sedated, but will more than likely be asleep.

Step 1: Incision
During the surgery, the surgeon will begin by making an incision on top of or around the abscess using a 15 blade. This incision allows the surgeon to access the abscess and drain any accumulated pus.

Step 2: Exploration
Once the incision has been made, the surgeon will explore the abscess using a hemostat, and may also require the use of metzenbaums if the abscess is deep.

Step 3: Culturing
As the abscess will have already started to leak at this point, the surgical technologist needs to have culture swabs available to obtain samples from the ruptured abscess for testing. This is essential in identifying the type of bacteria causing the abscess.

Step 4: Drainage
After exploring the abscess, the surgeon will drain the area of any pus and debris. Raytecs or laps should be available as the surgeon will require multiple of them, depending on the size of the abscess.

Step 5: Irrigation and Closure
Once the area has been drained, it will be irrigated to eliminate any remaining debris or bacteria. The surgeon may then suture the area closed or insert a penrose drain. If a penrose drain is used, the surgical technologist will need to ensure that it is cut and sutured in place correctly.

Step 6: Dressing
Typically, dressings are not used for these types of incisions. However, the surgeon may request an ABD pad and mesh panties to be placed over the site. The surgical technologist should ensure that the dressing is applied correctly.

Tips and tricks
Some may not use a mayo stand while setting these surgeries up, but feel free to use whatever you are comfortable with.

The Surgery Sparknotes

1. Make incision with 15 blade
2. Explore abscess with hemostats and metzenbaums
3. Use culture swabs to collect samples from abscess
4. Drain abscess with raytecs or laps
5. Irrigate and suture or insert penrose drain
6. Apply ABD pad and mesh panties as necessary