Why Is My Fistula Surgery Wound Not Healing After Two Months?

Why is the wound not healing after fistula surgery?

However, the problem is that the wound has not completely closed yet...
I consulted the original doctor, but he couldn't provide a reason...
May I ask: 1.
The original doctor said it would take a month and a half to heal completely, but it has now been two and a half months and it still hasn't closed.
Is this situation normal? (He mentioned that the fistula is very deep and close to the vagina, which is why the healing is slow?) 2.
What should I do if the wound still hasn't closed? Do I need to undergo surgery again? (After the previous surgery, I went for dressing changes every day for the first two weeks, and then less frequently.
Last week, everything was said to be normal, but this week I was told there is an issue.
He said the wound is not healing properly...
what does this mean?) 3.
What could be the reason for the wound not closing? 4.
The doctor said that if it doesn't heal, he will reopen the surface to allow more air exposure to promote closure.
Is this really guaranteed to lead to complete healing? Is this medical approach correct, or are there other methods to help with closure? 5.
I have been following the doctor's instructions for dressing changes, but I'm really scared that it still hasn't closed...
I'm afraid he will say I need to reopen it and experience pain again...
When he says to reopen, does that mean just the surface, or does it involve reopening everything and starting over? I feel really helpless...
Please help me, doctor...

Ms. Huang, 30~39 year old female. Ask Date: 2017/02/25

Dr. Ke Fangxu reply Surgery

If it hasn't healed after such a long time, it is possible that the fistula was not completely excised.
In such cases, oral antibiotics are typically administered first.
If there is still no improvement, a repeat surgery is recommended.
Rather than just opening the surface, it is better to reoperate to ensure thorough cleaning.

Reply Date: 2017/02/25

More Info

The healing of a fistula surgery wound can be a complex process, and it's understandable that you are feeling anxious about the situation, especially after two and a half months without complete closure. Let's address your concerns systematically.

1. Is it normal for the wound to not be fully healed after two and a half months?
Healing times can vary significantly based on several factors, including the depth of the fistula, its location (in your case, near the vaginal area), and individual patient factors such as overall health, nutrition, and any underlying conditions. Fistulas can be particularly challenging to heal because they often involve complex tissue structures and may be subject to ongoing irritation or infection. While your doctor initially estimated a healing time of about six weeks, it is not uncommon for deeper or more complicated fistulas to take longer to heal.
2. What should be done if the wound is not closing?
If the wound is not closing, it is essential to maintain regular follow-ups with your healthcare provider. They may consider several options, including conservative management (continued wound care), additional imaging to assess the fistula's depth and complexity, or surgical intervention if necessary. Reopening the wound to allow more air exposure can sometimes promote healing, but this decision should be made carefully by your surgeon based on a thorough assessment of your specific situation.

3. What could be causing the lack of closure?
Several factors can contribute to delayed healing of a fistula wound:
- Infection: Persistent infection can impede healing. Signs of infection include increased redness, swelling, warmth, or discharge.

- Tissue Health: Poor blood supply or unhealthy tissue can slow healing.
- Mechanical Factors: Activities that put strain on the area, such as sitting for long periods or certain movements, can affect healing.

- Underlying Conditions: Conditions like diabetes or autoimmune disorders can also impact wound healing.

4. Is the proposed method of reopening the wound a valid approach?
Your doctor’s suggestion to reopen the wound to promote healing is a recognized approach in some cases. This method allows the wound to be exposed to air, which can sometimes facilitate healing. However, it is crucial to discuss the potential risks and benefits with your surgeon. They will assess whether this approach is appropriate based on the current state of your wound and your overall health.

5. What if I am afraid of reopening the wound?
It is completely normal to feel apprehensive about the prospect of further surgery or reopening the wound. Open communication with your healthcare provider is key. Discuss your fears and ask about the specific procedures involved. Understanding what to expect can help alleviate some anxiety. Additionally, inquire about pain management strategies that can be employed during any necessary procedures.

In conclusion, while it can be frustrating and concerning to experience delayed healing of a fistula surgery wound, it is essential to work closely with your healthcare provider to explore all options. They can provide tailored advice based on your specific case and help you navigate this challenging situation. Remember, healing is a process, and it is important to be patient and proactive in your care.

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