Abscesses usually burst and heal spontaneously, or cause so much pain that surgery is needed. A non healing abscess near the anal orifice is likely to be the external opening of a fistula. An anal fistula is an abnormal communication between the anal canal and the skin. The fistula track starts about 4 cm inside the anal orifice, and comes out in the skin near the anus.There are two types of treatment. One is surgery, which is effective but has a recurrence rate of about 15%. The other is a thread therapy being carried out at Moolchand Hospital: there is no surgery, and the recurrence rates are probably lower.