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Have open sore on cheek of butt and rash on rectum. On antibiotic but no help. Suggest?

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General Surgeon
Practicing since : 2008
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Question
I have an open sore on my left cheek of my butt close to the rectum plus a rash into my rectum. I am on my last week of antibiotics but it doesn't heal. The would is red and wet. What should I do?
Posted Thu, 17 Oct 2013 in Abdominal Pain
 
 
Answered by Dr. Grzegorz Stanko 1 hour later
Brief Answer:
Anal fissure.

Detailed Answer:
Hello!

Thank you for the query.

Wound close to the rectum is usually caused by a connection between the rectum and the skin. This connection is caused by pathological canal and called anal fissure. Through this canal bacteria from the stool are infecting soft tissues. This causes red, painful wound close to the rectum, yellow or white discharge and pain.
Antibiotic wont heal it as long as there is connection between the rectum and skin.

I suggest you to visit general surgeon. Rectal examination, rectoscopy and MRI should be done.

Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Have open sore on cheek of butt and rash on rectum. On antibiotic but no help. Suggest? 48 minutes later
Is there anyway I can soak the soar?
 
 
Answered by Dr. Grzegorz Stanko 11 minutes later
Brief Answer:
.

Detailed Answer:
It might be hard to heal it if there is a connection with rectum. You may try to wash it with soap and water (this sounds simple but can be really effective) and have sitz baths with Potassium permanganate.
Please attach a picture of your wound to this conversation if possible so I can give more accurate answer.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have open sore on cheek of butt and rash on rectum. On antibiotic but no help. Suggest? 5 hours later
Picture attached .
 
 
Answered by Dr. Grzegorz Stanko 18 hours later
Brief Answer:
.

Detailed Answer:
OK. this wound does not look bad. In this area pilonidal cyst should be also considered. Here is what you should do:
- general surgeon consult first (in case of pilonidal cyst, surgery can be peformed after acute inflammation healing)
- swab test to determine which bacteria is causing it
- blood sugar level (diabetes makes you prone to skin infections)

To accelerate healing you may try Granuflex Wound dressing.

Hope this will help.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Have open sore on cheek of butt and rash on rectum. On antibiotic but no help. Suggest? 19 hours later
Hello and thank you for your response:

I ordered from the local pharmacy Potassium permanganate for a sitz bath, should I still use that. It will be available this morning.

If this doesn't go away, my doctor is on vacation but has a replacement and he told me to make arrangements to see her if the antibiotics don't clear up my sore.

Should I tell her what I've tried to clear it up? I am so uncomfortable I can hardly stand it. I sit down a lot because I had a pannulectomy in July and am not supposed to lift, stretch or bend because I need to have more surgery because one side of my pannus hasn't gone down and I have to have more surgery and was told to continue doing what I was told to do after my surgery.

I hope you can help me before I have to see the doctor.

Thanks, XXXXXXX
 
 
Answered by Dr. Grzegorz Stanko 8 hours later
Brief Answer:
.

Detailed Answer:
You can still use Potassium permanganate. It has good antibacterial effect. And you can tell your doctor about its usage.
Long sitting on this area is a very important fact. This can be the main reason of this wound.
Please try to avoid sitting on this part of your body. In my opinion, antibiotic is not necessary as this wound looks superficial.

Hope this will help.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Have open sore on cheek of butt and rash on rectum. On antibiotic but no help. Suggest? 1 hour later
Hello:

How do I apply the Potassium permanganate and in what form to my wound???

Sincerely, XXXXXXX
 
 
Answered by Dr. Grzegorz Stanko 11 hours later
Brief Answer:
detailed below

Detailed Answer:
You should dissolve a tablespoon of it in water and sit in it for about 5-10 minutes.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have open sore on cheek of butt and rash on rectum. On antibiotic but no help. Suggest? 3 hours later
Thank you. I'll give it a try.

Does it hurt the other skin around it if I sit in it?

Could I put the solution on my wound on a dressing and change it regularly for 5 minutes?

Sincerely, XXXXXXX
 
 
Answered by Dr. Grzegorz Stanko 4 hours later
Brief Answer:
detailed below.

Detailed Answer:
It just hurts the area where the pressure is applied during sitting. Its because the blood circulation to the compressed skin is blocked so it gets necrotic.
You can put the solution on the dressing and keep it for some time (like 10-15 minutes). No need to change it every 5 minutes.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have open sore on cheek of butt and rash on rectum. On antibiotic but no help. Suggest? 2 hours later
Thank you. I made a mess trying to sit in it so I'll do the dressing.
 
 
Answered by Dr. Grzegorz Stanko 18 hours later
Brief Answer:
.

Detailed Answer:
You are welcome. Dressing is fine. Just remember to make a break from sitting on this area.
Regards.
Above answer was peer-reviewed by
 
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