title: Identification of the internal anal opening and seton placement improves the outcome of deep postanal space abscess.
abstract: OBJECTIVE
  This study aimed to determine if successful seton placement at the initial drainage procedure improves outcomes in the management of deep postanal space abscesses.
  
  
  METHODS
  A retrospective review was performed of all patients who underwent initial drainage of a DPA space abscess between December 2002 and August 2010. A seton was placed through the internal opening if it could be identified.
  
  
  RESULTS
  Thirty-two patients of median age 41 (21-64) years formed the study group. Twenty-four (75.0%) had a seton inserted at the initial drainage procedure. The patients underwent a total of 56 operations. The median interval from the initial to the final operation was 5 (2-18) months with 17 (70.8%) patients having the final operation within 6 months. In the 8 (25.0%) patients whose internal opening could not be found, 26 operations were required with a median interval from the initial to the final surgery of 11 (3-24) months. Patients who had a seton successfully inserted at drainage underwent significantly earlier definitive surgery and required fewer operations (P < 0.038).
  
  
  CONCLUSIONS
  Identification of an internal opening with placement of a seton at the initial drainage procedure is associated with earlier definitive surgery and fewer operations.
authors.affiliation: National University Health System, Singapore City, Singapore.
authors.forename: K-K
authors.initials: KK
authors.lastname: Tan
authors.forename: X
authors.initials: X
authors.lastname: Liu
authors.forename: C B
authors.initials: CB
authors.lastname: Tsang
authors.forename: D C
authors.initials: DC
authors.lastname: Koh
mesh_terms: D000038:Abscess / Q000601:surgery*; D000328:Adult; D001003:Anal Canal / Q000473:pathology / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013537:Sutures; D055815:Young Adult