Post-Surgery Concerns: Bright Red Blood on Gauze After Fistula Surgery

Post-operative gauze from anal fistula surgery is blood-red in color?

Hello, Director Ke.
It has been 4 days since the fistula excision surgery on August 7.
While in the hospital, the nurse informed me that if the blood on the dressing is bright red, and if the wound appears swollen or painful, I should return to the hospital.
Since being discharged, I have experienced more pain than during my hospital stay, where the pain was minimal (I was taking pain medication both during and after hospitalization).
The blood stains on the dressing since discharge seem deeper than when I was in the hospital, with bright red and some dark brown areas.
I have attached a picture: https://imgur.com/a/uuqzE.
Aside from after a bowel movement, the pain is bearable, but I am concerned about the increased pain and the redness on the dressing.

1.
I would like to ask if this is a normal situation, or could it indicate that the wound has opened or other issues? Should I return to the hospital for evaluation?
2.
Additionally, I would like to know if going up and down stairs during the recovery period could strain the wound and affect the healing process.
Thank you, doctor.

Xiao Xiu, 20~29 year old female. Ask Date: 2017/08/11

Dr. Ke Fangxu reply Surgery

1.
The wound is indeed bleeding, but the bleeding is not severe enough to require immediate medical attention.
If the bleeding becomes severe enough to stain the toilet red, then a doctor should be consulted.

2.
Generally, this is not the case; as long as you don't go up and down several flights of stairs in a day, there should be no impact.

Reply Date: 2017/08/11

More Info

After undergoing fistula surgery on August 7, it is understandable to have concerns about post-operative symptoms, especially when it comes to bleeding and pain. Based on your description, it seems that you are experiencing bright red blood on the gauze, increased pain compared to your hospital stay, and some discoloration of the blood. Let's address your concerns one by one.

1. Bright Red Blood on Gauze: It is not uncommon to see some bleeding after surgery, particularly in the first few days as the body begins to heal. Fresh red blood typically indicates active bleeding, which can be a result of various factors, including irritation of the surgical site, increased activity, or even constipation leading to straining during bowel movements. However, if the bleeding is significant or if you notice a sudden increase in the amount of blood, it is crucial to seek medical attention. The fact that you are experiencing more pain and seeing deeper red blood could suggest that there may be some irritation or even a complication such as a wound dehiscence (where the surgical wound reopens).
2. Pain Levels: It is not unusual for pain levels to fluctuate after surgery. While some patients may experience less pain during their hospital stay due to the administration of pain medications, it is also possible for pain to increase once those medications are reduced or stopped. If the pain is manageable and does not worsen significantly, it may be part of the normal healing process. However, if the pain becomes severe or is accompanied by other symptoms such as fever, increased swelling, or persistent bleeding, you should contact your healthcare provider.

3. Returning to the Hospital: Given your symptoms of increased pain and bright red blood, it would be prudent to consult your surgeon or return to the hospital for an evaluation. They can assess the surgical site to determine if there are any complications that need to be addressed. It is always better to err on the side of caution when it comes to post-operative care.

4. Activity and Recovery: Regarding your question about going up and down stairs, it is important to listen to your body during the recovery period. While light activity is generally encouraged to promote circulation and healing, excessive strain or heavy lifting can potentially affect the surgical site. If you feel that climbing stairs is causing discomfort or pulling at the wound, it may be wise to limit such activities until you have a follow-up appointment with your surgeon.
In summary, while some bleeding and pain can be expected after fistula surgery, the presence of bright red blood and increased pain warrants further evaluation. It is essential to communicate with your healthcare provider about your symptoms, as they can provide personalized advice and determine if any interventions are necessary. Recovery from surgery can be a gradual process, and taking care of yourself during this time is crucial for a successful outcome.

Similar Q&A

Post-Operative Concerns After Anal Fistula Surgery: Bleeding and Recovery

It has been two weeks since the anal fistula surgery (traditional excision) on April 5th, but I occasionally experience significant bleeding (the entire gauze is soaked) and sometimes very little or none (just a small area in the center of the gauze). Is this a normal occurrence?...

Dr. Ke Fangxu reply Surgery
After a fistula surgery, there should not be significant bleeding two weeks post-operation. However, if there is a pre-existing hemorrhoid issue, combined with postoperative constipation, it can easily lead to rectal bleeding. Coughing and sneezing can also increase pressure in t...

Post-Surgery Concerns: Managing Granulation Tissue Inflammation After Fistula Surgery

Hello, doctor. It has been about a month since my fistula excision surgery (the doctor informed me that the wound healing requires at least 2 months). Recently, I noticed yellow spots that look like pus on the newly formed granulation tissue (the color is more yellow compared to ...

Dr. Ke Fangxu reply Surgery
If there is no redness, swelling, heat, or pain, you can continue to observe the healing process of the wound. The appearance of granulation tissue is a normal phenomenon. If there is not much discharge, it is not a concern. However, if there is brown or green purulent discharge,...

Is Blood in Stool Normal After Fistula Surgery?

Hello, doctor. I had a fistula surgery on September 5th. I noticed blood in my stool for the first time, and the second time there was a lot of blood, which was bright red. Is this normal?

Dr. Ke Fangxu reply Surgery
Mild bleeding after fistula surgery is a normal occurrence; however, if there is significant bleeding, it is considered abnormal. It is recommended that you consult the surgeon for an evaluation, and if necessary, medication may be administered for hemostatic treatment.

Managing Suture Dehiscence After Fistula Excision Surgery

Hello Dr. Chang, Today is the third day post-fistula excision surgery. While caring for the wound, I noticed that the original sutures have come undone. Should any action be taken? There is no significant bleeding from the wound, only some blood when wiping after using the rest...

Dr. Zhang Shuhao reply Surgery
The fistula surgery uses absorbable sutures, which will mostly start to fall out in about a week. However, if they fall out earlier, it is not a concern. As long as there is no bleeding, you can continue with the usual care, including taking warm sitz baths and changing the ointm...