Post-Surgery Concerns: Anal Abscess Recovery Issues - Surgery

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Postoperative Issues Following Perianal Abscess Surgery


Hello! On August 10, I underwent surgery due to an abscess located in the rectal area.
The physician performed an incision and drainage procedure and indicated that the suspected internal opening was also excised.
Currently, there is an open wound near the rectum that cannot be sutured, as it is not possible to clean or apply medication to the wound in that area.
It is expected that granulation tissue will grow from the base to fill the wound.
It has been almost five weeks since the surgery, during which I have had continuous follow-up visits and have been instructed to keep the wound open to prevent premature healing.
The physician mentioned that the wound is approximately the size of half a finger.
Now, when I stretch the anal opening, there is still yellow discharge coming from the rectum, and I experience pain in the muscles/soft tissue near the coccyx, especially after bowel movements.
I am concerned whether this is normal or if the surgery was unsuccessful.
I am also worried about the possibility of the abscess recurring or developing in other areas.
Additionally, the physician stated that the yellow discharge is likely fecal matter and that the pain is due to previous inflammation that has not healed.
However, I feel that it does not resemble fecal matter.
Is the yellow discharge pus or intestinal fluid? Could the pain be caused by the presence of pus again? Thank you for your response.

Hua, 30~39 year old female. Ask Date: 2017/09/14

Dr. Ke Fangxu reply Surgery


After an anal abscess surgery, the wound typically takes about a month to heal.
Of course, if the wound is larger, the healing period will be longer.
I don't understand why it's necessary to keep the wound open after surgery, but there is a possibility of developing an anal fistula postoperatively.
I cannot tell you what the discharge is because I haven't seen it firsthand.
As for the pain, I cannot determine whether it is due to the wound not healing or a recurrence of the disease, as I cannot assess the condition without a physical examination.
I recommend discussing your condition and treatment plan in detail with your surgeon for better understanding and management of your progress.

Reply Date: 2017/09/14

More Info


Post-surgery recovery from an anal abscess can be a complex and sometimes concerning process. It’s understandable to have questions and worries, especially when dealing with symptoms like pain and unusual discharge. Let’s break down your situation and address your concerns.

Firstly, it’s important to recognize that after surgery for an anal abscess, it is common to have an open wound that needs time to heal. The fact that your doctor has indicated that the wound cannot be sutured and must heal from the inside out is a typical approach in such cases. This method allows for proper drainage and reduces the risk of infection, which is crucial for healing.

You mentioned that it has been about five weeks since your surgery, and you are still experiencing yellow discharge from the area. The presence of discharge can be concerning, but it is not uncommon in the healing process. The yellow color of the discharge could be due to several factors. It might be a combination of pus, which is a sign of infection, or it could be a mixture of fecal matter and bodily fluids, especially if there is still some inflammation in the area. Your doctor’s assessment that the discharge is likely fecal matter should be taken seriously, as it indicates that the healing process may not be complete, and there could be a risk of further complications.

Pain after such a procedure is also expected, particularly after bowel movements. The anal region is sensitive, and any surgical intervention can lead to increased sensitivity and discomfort during the healing phase. However, if the pain is severe or worsening, it could indicate that there is an underlying issue, such as an infection or a recurrence of the abscess.

Regarding your concerns about the possibility of the abscess recurring, it is essential to monitor your symptoms closely. If you notice increased swelling, redness, or a significant change in the discharge (such as an increase in pus or a foul odor), you should contact your healthcare provider immediately. These could be signs of a recurrence or a new infection.

As for your worries about the yellow discharge and whether it is pus or intestinal fluid, it is crucial to follow up with your doctor. They may recommend further evaluation, such as a physical examination or imaging studies, to determine the nature of the discharge and the status of your healing. If there is any suspicion of infection, they may prescribe antibiotics or other treatments to address the issue.

In the meantime, here are some general recommendations for managing your recovery:
1. Hygiene: Keep the area clean and dry. While you may not be able to wash the wound directly, gentle cleaning around the area with mild soap and water can help prevent infection.

2. Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage discomfort. However, consult your doctor before taking any medication.

3. Diet: A high-fiber diet can help prevent constipation, which can exacerbate pain during bowel movements. Staying hydrated is also essential.

4. Follow-Up Care: Continue to attend all follow-up appointments with your healthcare provider. They will monitor your healing progress and address any concerns you may have.

5. Watch for Symptoms: Be vigilant for any signs of complications, such as increased pain, fever, or changes in the discharge.

In conclusion, while some discharge and pain can be normal after anal abscess surgery, it is crucial to stay in close contact with your healthcare provider to ensure proper healing and to address any potential complications. If you have any doubts or if your symptoms worsen, do not hesitate to seek medical advice. Your health and recovery are the top priorities.

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