Objective <p>This study aimed to analyze the distribution characteristics of infecting microorganisms in the wound tissue of patients with perianal abscess and infection, as well as to identify factors affecting wound healing.</p> Methods <p>Two hundred patients with perianal abscess combined with infection admitted to our hospital from January 2023 to May 2024 were selected, all of whom underwent one-time radical surgery, and were divided into 155 cases with good quality of healing and 45 cases with poor quality of healing according to the healing status of wounds in the 2 weeks after surgery, and the traumatized tissue specimenss were collected for the cultivation and identification of infecting microorganisms to analyze the characteristics of the distribution of infecting microorganisms. The clinical data of the patients were collected, and the factors affecting wound healing were investigated using unifactorial and multifactorial analysis.</p> Results <p>In this study, 316 strains of infecting microorganisms were detected in two hundred patients, including 213 Gram-negative bacteria, 80 Gram-positive, and 23 fungal strains, of which the Gram-negative bacteria were dominated by <i>Escherichia coli</i> (<i>E. coli</i>)and <i>Klebsiella pneumoniae(K. pneumoniae)</i>, and the Gram-positive bacteria were dominated by Staphylococcus aureus. The results of univariate analysis showed that body mass index, diabetes mellitus, concomitant infections, and stool traits were influential factors affecting the poor quality of wound healing (<i>P</i> &lt; 0.05). The results of multifactorial logistic regression analysis showed that body mass index, diabetes mellitus, concurrent infections and stool traits were independent risk factors influencing the poor quality of wound healing (<i>P</i> &lt; 0.05, <i>P</i>&lt;0.05 indicates that the factor is statistically significant).</p> Conclusion <p>This study suggests that BMI, diabetes, concurrent infection and stool characteristics are independent risk factors for poor wound healing in patients with perianal abscess and infection. In clinical practice, it is recommended to implement personalized interventions targeting the above factors (such as optimizing nutritional support, strict blood glucose control, strengthening infection management, etc.) to improve patient prognosis. In the future, the universality of this conclusion needs to be further verified through multi center and large sample studies.</p>