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Saw my surgeon yesterday for my exploratory evaluation, etc. We talked about the possibility of my abscess being a fistula because at a prior appointment, the Physicians Assistant noticed that the tract was deep and continuously draining.

After my surgery, my surgeon told me that they didn't insert a seton because the abscess did not appear to be a fistula. Rather, he removed the infected tissue and left the wound open to heal on its own. He also prescribed flagyl and said he wanted to "dry it out".

I've had three perianal abscesses since 2004. Two required setons and one surfaced on its own and never returned. I'm paranoid now that they should have just gone ahead and inserted a seton. I'm confident that they did remove the inflamed tissue because the area where the nodule was is completely opened up and hollowed out but I'm still skeptical and fear that there is the chance it could heal up and reoccur (assuming this is a fistula).

Has anyone had a situation like this where they did not insert a seton and just opened up the area work over the long term?
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Yes, Dan, you are correct. I was just surprised that they saw no tract because after two visits to the doctor to excise the abscess, it was still draining. I would have put money down that it was a fistula but when the surgeon went in on Thursday to do an exploratory procedure, he never found any tracts so he just removed the entire abscess. I hope he's right in that this is all there was. Would hate to have to go through all this again.

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