Post-Surgery Recovery: Managing Pain and Complications After Anal Abscess

Wound healing after an anal abscess?

Hello, doctor.
I underwent a surgical procedure for an anal abscess on May 22, where tissue was excised, resulting in a hole about the size of a 10 NT dollar coin.
The surgery lasted less than 2 minutes (it was not a fistula surgery).
I had a follow-up appointment a week post-operation, and at that time, the swelling was still present.
I was advised to continue sitz baths and monitor my diet, with another follow-up scheduled for the end of June.
I have been taking sitz baths daily, and the wound has been gradually shrinking and healing since about two weeks post-surgery.
The swelling has mostly disappeared, and for the past 4 to 5 days, there has been no pus coming from the wound, and some scabbing has occurred.
Therefore, for the past couple of days, I have only been taking sitz baths at night, using warm water for cleansing at other times, and I just stopped using gauze a couple of days ago.
However, yesterday I felt a slight stinging sensation near the wound.
Upon closer inspection, I noticed a small blister about 0.5 cm away from the wound (the wound is next to the anus, not on it, and the new blister is on the side away from the anus).
The blister is white and raised; when I tried to touch it while showering (without squeezing), it burst.
After it burst, I only got a small amount of clear fluid when I squeezed it, so I reapplied gauze last night.
This morning, I saw only a small bloodstain the size of the blister on the gauze, with no yellow-green fluid.
1.
Could this be a fistula forming another opening, or is it possible that the prolonged use of gauze and tape over the past three weeks has caused the skin to become irritated and develop a pimple?
2.
Given that my next follow-up is at the end of June, is there a risk that this could worsen into a complex fistula within the next 10 days?
3.
Is sitz bathing suitable for women? Is there a risk of infection since the genital area is also submerged in water during the bath?

You, 30~39 year old female. Ask Date: 2017/06/18

Dr. Ke Fangxu reply Surgery

1.
Both possibilities exist; I suggest you avoid using gauze for now and observe.
If you are concerned about discharge, you can use panty liners.

2.
The formation of a fistula is not related to these past ten days, so there is no need to worry about developing a complex fistula as a result.

3.
The duration of sitz baths should not be too long.
Common discomfort in the perineum after sitz baths is often due to the excessive addition of povidone-iodine, as a high concentration can irritate the skin or mucous membranes.
If you experience this, it is advisable to soak in plain water instead.

Reply Date: 2017/06/18

More Info

Post-surgery recovery, especially after a procedure like an anal abscess drainage, can be a challenging journey. It’s essential to understand the healing process, manage pain effectively, and recognize potential complications. Based on your description, it seems you are making progress, but there are some concerns that need to be addressed.

1. Understanding the Symptoms: The small water blister you noticed near the surgical site could be a few things. It might be a localized reaction to irritation, possibly due to the adhesive from the bandages or the friction from clothing. It’s also possible that it could be a sign of an infection or a developing fistula, especially if it continues to produce fluid or if you notice increasing pain or redness. Fistulas can occur after abscess drainage, but they typically present with more persistent symptoms. Given that you have already experienced some drainage and now have a blister, it’s crucial to monitor the area closely.

2. Risk of Complications: The concern about the potential development of a complex fistula is valid. While it’s unlikely that a new fistula would develop in just ten days, it’s essential to keep an eye on any changes. If you notice increased pain, swelling, or discharge that is yellow or green, these could be signs of infection or complications. It’s advisable to reach out to your healthcare provider sooner than your scheduled appointment if you experience any worsening symptoms.

3. Sitz Baths and Hygiene: Sitz baths are generally recommended after anal surgeries as they can help soothe the area, promote healing, and keep the surgical site clean. However, it’s crucial to ensure that the water is clean and that you are not sitting in water that could introduce bacteria. For females, while sitting in a bath, there is a slight risk of introducing bacteria from the vaginal area to the surgical site, especially if the water is not clean. It’s essential to maintain good hygiene, and if you have any concerns about infection, consider using a clean, shallow basin for sitz baths and avoid submerging the area in a larger bath where bacteria could be present.

4. Managing Pain and Discomfort: Pain management is a critical aspect of recovery. Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage discomfort. Additionally, applying a cold compress to the area may reduce swelling and pain. If the pain persists or worsens, it’s essential to consult your doctor for further evaluation and management.

5. Follow-Up Care: Since you have a follow-up appointment in late June, it’s crucial to keep that appointment. However, if you notice any concerning symptoms before then, don’t hesitate to seek medical attention. Your healthcare provider can assess the area and determine if further intervention is necessary.

In summary, while it sounds like you are on the right track with your recovery, it’s essential to remain vigilant about any changes in your symptoms. Continue with your sitz baths, maintain good hygiene, and monitor the surgical site closely. If you have any doubts or concerns, reaching out to your healthcare provider sooner rather than later is always a good idea. Your health and comfort are paramount, and proactive care can help prevent complications.

Similar Q&A

Post-Surgery Concerns After Anal Abscess and Fistula Procedure: Expert Advice Needed

I underwent surgery for an anal abscess and a mild fistula at China Medical University in Taichung on November 6th. Today is the fifth day post-operation, and I would like to ask the physician a few questions regarding my recovery: 1. If I experience frequent diarrhea after tak...

Dr. Ke Fangxu reply Surgery
1. Laxatives are prescribed to prevent postoperative constipation; if diarrhea occurs, the dosage should be reduced or the medication should be discontinued. 2. Based on this description alone, it is not possible to determine whether it is related to the surgery; a consultation...

Post-Surgery Care for Anal Abscess and Fistula: Pain Management Tips

Hello Dr. Ke, I just had surgery for an anal abscess and fistula on May 19, 2021. After the surgery, I have been experiencing significant pain while applying medication. I have been doing sitz baths and using nine cotton swabs, five of which are soaked in Betadine and four in sal...

Dr. Ke Fangxu reply Surgery
1. As long as you avoid inserting cotton swabs or gauze, it shouldn't be as painful. It's recommended to take warm sitz baths, and there's no need for special cleaning of the wound internally; rinsing with a handheld showerhead is also acceptable. 2. The first we...

Post-Surgery Care for Anal Abscess: Managing Symptoms and Recovery

1. Symptoms: Today, I sought medical attention due to swelling and sharp pain at the six o'clock position of the anus. The doctor used a syringe to aspirate the contents, which contained some pus and blood (mostly blood), and diagnosed me with an anal abscess. 2. I would l...

Dr. Chen Jiaming reply Surgery
It is possible to recover from this infection; however, if it is caused by a fistula, there is a higher likelihood of recurrence. Therefore, if similar symptoms occur in the future, it is essential to seek treatment as soon as possible.

Post-Surgery Care for Anal Abscess: Understanding Healing and Pain

Hello, doctor! Two weeks ago, I underwent an anesthesia drainage surgery for an anal abscess at the Rectal Surgery Department of Nanmen Hospital. After changing the dressing three days later, the doctor said my recovery was normal and advised against packing the wound with gauze....

Dr. Yu Mingchang reply Surgery
Hello: Please come in for a follow-up appointment to check if the swelling is just a simple injury. The Ministry of Health and Welfare Changhua Hospital cares about you.