Post-Surgery Concerns: Managing Pus After Anal Fistula Surgery

Postoperative suppuration after anal fistula surgery?

Hello Dr.
Hsu: About a week ago, I underwent a fistula surgery at Linkou Chang Gung Memorial Hospital (the external opening is located about 3 cm below the testicle).
During the surgery, the doctor also removed hemorrhoids from my anal area.
For the past week, I have been following the instructions in the educational manual, continuing to take sitz baths 3 to 4 times a day, and I always take a sitz bath for 5 to 10 minutes after bowel movements.
Although the bleeding has slightly improved, with less blood on the gauze, I have noticed a white, pus-like discharge from the sutured area between the anus and the external opening near the testicle, which is adhering to the wound.
I would like to ask Dr.
Hsu if this situation is normal.
I am really worried that the internal opening was not cleaned out properly and that I may need another surgery...

Jingyang, 20~29 year old female. Ask Date: 2016/05/15

Dr. Xu Kaixi reply Surgery

Based on your description, this situation seems more like exudate from the wound healing process adhering to the wound.
If you have concerns or notice any other changes, it is advisable to return to the surgical outpatient clinic for a follow-up examination of the wound healing status after the fistula surgery.

Reply Date: 2016/05/15

More Info

After undergoing anal fistula surgery, it is common to have concerns about the healing process and any potential complications that may arise. Based on your description, it seems that you are experiencing some discharge from the surgical site, which can be a source of anxiety. Let's address your concerns systematically.

1. Understanding Post-Surgery Discharge: It is not uncommon to see some discharge after anal fistula surgery. The presence of white, pus-like discharge can indicate a few things. In the early stages of healing, it may simply be a part of the normal healing process, especially if the discharge is not accompanied by significant pain, redness, or swelling. However, if the discharge has a foul odor or is accompanied by increased pain or fever, it could indicate an infection, and you should contact your healthcare provider immediately.

2. Normal Healing Process: After surgery, the body goes through a healing process that can involve the formation of granulation tissue, which may appear as a whitish or yellowish discharge. This is a normal part of healing as the body works to close the surgical site. The fact that you are following the recommended sitz baths and maintaining hygiene is excellent, as these practices can help promote healing and reduce the risk of infection.

3. When to Seek Help: If the discharge persists or worsens, or if you experience increased pain, fever, or any other concerning symptoms, it is crucial to consult your surgeon. They may want to evaluate the surgical site to ensure that there are no complications, such as an abscess or incomplete healing of the fistula.

4. Concerns About Reoperation: It is understandable to worry about the possibility of needing another surgery. However, many patients experience successful healing without the need for additional procedures. Your surgeon will be able to assess the situation and determine if further intervention is necessary based on your symptoms and the appearance of the surgical site.

5. Post-Operative Care: Continue to follow the post-operative care instructions provided by your healthcare team. This includes maintaining cleanliness, using sitz baths, and monitoring your symptoms closely. If you notice any changes in the discharge or if you have concerns about your healing process, do not hesitate to reach out to your healthcare provider for guidance.

6. Long-Term Outlook: Many patients who undergo anal fistula surgery experience significant relief from their symptoms and a return to normal bowel function. It is essential to be patient with the healing process, as it can take time for the body to fully recover. Regular follow-up appointments with your surgeon will help ensure that your recovery is on track.

In summary, while some discharge after anal fistula surgery can be normal, it is essential to monitor your symptoms closely. If you have any concerns about the nature of the discharge or your overall recovery, do not hesitate to consult your healthcare provider for reassurance and guidance. Your proactive approach to your recovery is commendable, and staying informed will help you navigate this healing process more effectively.

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