Which treatment is never performed simultaneously with abscess drainage in high anal fistulae?

In the context of managing high anal fistulae, fistulotomy is a treatment that is generally avoided during the simultaneous drainage of an abscess. This is primarily due to the risk of exacerbating the condition and increasing the complexity of the surgical procedure. Fistulotomy involves cutting open the fistula tract to allow it to heal from within; when performed in the presence of a high anal abscess, it can lead to increased morbidity, such as complications related to healing, incontinence, or infection.

On the other hand, the other treatments mentioned, such as anal fistula plugs, seton placement, and anorectal advancement flap, can be employed in conjunction with abscess drainage. These methods focus on addressing the fistula while managing the abscess, ensuring that the acute issue of the abscess is resolved without compromising the overall management of the fistula itself.

Overall, the key aspect of this question lies in understanding the surgical principles that guide the management of high anal fistulae and the implications of performing certain procedures in the presence of an acute abscess.