Post-Surgery Pain and Discomfort: Sutures and Healing

The surgical incision site often feels painful and burning?

Hello Dr.
Ke: My original fistula opening was located about 3 centimeters below the testicle.
I underwent fistula excision surgery on May 12, and it has been 4 months since then.
During my follow-up appointment on August 18, the doctor noted that the wound inside the anus still felt firm and had not completely healed.
Recently, although the external sutured area has healed, I still feel a swelling and tenderness inside.
I would like to ask Dr.
Ke what might be the cause of this.
P.S.
I take sitz baths three times a day and apply the healing ointment in the morning and evening.

Jingyang, 20~29 year old female. Ask Date: 2016/09/13

Dr. Ke Fangxu reply Surgery

Complex fistulas have larger surgical wounds, resulting in a longer recovery time.
Most patients will experience some degree of sharp pain at the surgical site.
It is generally recommended to use ointments and suppositories for a period of time, and then monitor the wound for signs of redness, swelling, heat, pain, or abnormal discharge.
If these symptoms are absent, there is usually no cause for concern; otherwise, it is advisable to consult a physician for further evaluation.

Reply Date: 2016/09/13

More Info

Post-surgery pain and discomfort can be a common experience for many patients, especially after procedures involving delicate areas such as the groin or anal region. In your case, having undergone a fistula excision surgery, it is understandable that you are experiencing lingering discomfort four months post-operation. Let’s delve into the potential reasons for your symptoms and discuss ways to manage them effectively.

Firstly, the sensation of a "hard" area and persistent swelling or tenderness at the surgical site can be attributed to several factors. After surgery, the body undergoes a healing process that involves inflammation, which is a natural response to injury. This inflammation can cause the surrounding tissues to feel swollen and tender. The fact that your external sutures have healed is a positive sign, indicating that the outer layer of skin has closed. However, the deeper tissues may still be healing, which can take longer and may result in discomfort.

Another possibility is the formation of scar tissue, which can occur as part of the healing process. Scar tissue can sometimes be denser and less flexible than the surrounding tissue, leading to a sensation of tightness or hardness. This can also contribute to discomfort, especially if the scar tissue is near sensitive areas or if it affects the surrounding nerves.

Additionally, if there was any infection or inflammation at the surgical site, this could also lead to prolonged discomfort. It is essential to monitor for any signs of infection, such as increased redness, warmth, or discharge from the site. If you notice any of these symptoms, it is crucial to contact your healthcare provider.

Regarding your daily sitz baths and the application of ointments, these practices are generally beneficial for promoting healing and comfort. Sitz baths can help reduce inflammation and provide relief from discomfort. However, if you are still experiencing significant pain or discomfort despite these measures, it may be worth discussing with your physician the possibility of other treatments. This could include physical therapy to help improve flexibility and reduce tension in the area or medications to manage pain and inflammation.

In terms of your question about whether this discomfort is normal, it is not uncommon for patients to experience varying degrees of pain and discomfort for several months after surgery. However, if the pain is severe or worsening, or if you have concerns about the healing process, it is essential to follow up with your surgeon or healthcare provider. They may recommend imaging studies or further evaluations to ensure that there are no complications, such as abscess formation or other issues that could be contributing to your symptoms.

In conclusion, while some discomfort after surgery is expected, persistent or severe symptoms warrant further investigation. Continue your sitz baths and topical treatments, but do not hesitate to reach out to your healthcare provider for a thorough evaluation and tailored advice. Your comfort and recovery are paramount, and addressing any concerns early can help facilitate a smoother healing process.

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