Post-Surgery Healing: Is Hardness Normal After Fistula Removal?

Anal fistula

Hello doctor, I had a fistula excision surgery at the beginning of March.
The original fistula was a blind type, and there was a hard, elongated area when pressed.
During the surgery, a piece of tissue the size of a thumb was removed.
Now, more than a month later, the wound has healed to the size of a little finger, but when I press on the healed area, it still feels hard.
I went for a follow-up appointment the day before yesterday but forgot to ask.
Is this normal? I heard the doctor say the wound has scabbed over, and I was given a tool to check my anal area twice.
Is the hardness I feel the internal scar from the scabbing?

Xiansheng, 20~29 year old female. Ask Date: 2017/04/08

Dr. Ke Fangxu reply Surgery

After anal fistula surgery, the formation of scar tissue at the wound site may lead to the sensation of a lump, which is a normal occurrence post-surgery.
As long as there is no redness, swelling, heat, pain, or purulent discharge, there is no cause for concern.
However, if this condition persists for two months, it is advisable to consult a physician for further evaluation.

Reply Date: 2017/04/08

More Info

After undergoing fistula removal surgery, it is not uncommon to experience some hardness or firmness in the area surrounding the surgical site. This can be attributed to several factors related to the healing process.
Firstly, the body’s natural healing response involves inflammation, which can lead to the formation of scar tissue. When tissue is damaged, the body sends cells to the area to repair it, which can result in a firmer texture as the new tissue forms. This is particularly true in the case of deeper wounds, such as those from a fistula removal, where the surgical intervention may have involved significant tissue manipulation.

In your case, since the surgery was performed in early March and you are now over a month post-operation, it is reasonable to expect some degree of hardness as part of the healing process. The fact that the wound has healed significantly, reducing from the size of a thumb to that of a small pinky, is a positive sign of recovery. However, the presence of hardness can sometimes indicate the formation of scar tissue, which is a normal part of healing but can sometimes lead to discomfort or a sensation of tightness.

Regarding the hardness you mentioned, it could indeed be related to the formation of scar tissue or the residual effects of the healing process. If the hardness is accompanied by pain, swelling, or any other concerning symptoms, it would be advisable to consult your surgeon for further evaluation. They may perform a physical examination to assess the area and determine whether the hardness is a normal part of healing or if it requires further intervention.

Additionally, the mention of crusting or scabbing is also typical after surgery, especially in areas where the skin has been disrupted. As the wound heals, it is common for scabs to form, which protect the underlying tissue as it regenerates. These scabs will eventually fall off as the healing progresses, revealing new skin underneath.
If you are experiencing any unusual symptoms, such as increased pain, redness, or discharge from the site, it is crucial to seek medical attention promptly, as these could be signs of infection or other complications.
In summary, while some hardness after fistula removal surgery can be normal due to scar tissue formation and the natural healing process, it is always best to discuss any concerns with your healthcare provider. They can provide reassurance and guidance tailored to your specific situation, ensuring that your recovery continues smoothly. Regular follow-up appointments are essential to monitor your healing and address any issues that may arise.

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