Fistula Healing: Seeking Expert Advice on Surgical Recovery - Surgery

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I would like to consult Director Ke regarding the issue of fistulas?


On October 6th of this year, I underwent surgery for a fistula, and it has now been seven weeks since the operation.
I have been attending regular follow-up appointments every week after the surgery.
My family has been using cotton swabs daily to disrupt the outer wound to prevent it from healing.
Today, the surgeon suggested that the healing from the inside out is progressing too slowly, and there may still be something inside.
He mentioned that the cotton swab could be inserted about 0.5 cm deeper.
He recommended that I go to a major hospital to see a specialist in colorectal surgery for further examination and possibly another procedure to dig deeper.
I am feeling anxious and unsure about where to go for this consultation, especially since I have been seeing the same doctor since June.
Can you provide any advice? Additionally, how long does it typically take for a wound to heal from the inside out? Thank you, doctor.

Xiao Yang, 30~39 year old female. Ask Date: 2017/11/21

Dr. Ke Fangxu reply Surgery


The healing time for anal fistula surgery typically takes about one month.
The recurrence rate after surgery also depends on the surgical method used.
Since I am unaware of your specific surgical technique, I cannot speculate on the issues you may be experiencing.
It is advisable to consult a colorectal surgeon for an examination to obtain a definitive diagnosis and appropriate treatment.

Reply Date: 2017/11/21

More Info


Fistula healing can be a complex and often frustrating process, especially when it involves surgical intervention. It sounds like you have been dealing with a challenging situation since your surgery on October 6th, and I understand your concerns regarding the slow healing of your wound.
First, let’s clarify what a fistula is. A fistula is an abnormal connection between two body parts, often resulting from injury, surgery, or infection. In your case, it seems that the surgical site is not healing as expected, which can happen for various reasons, including infection, inadequate drainage, or the presence of foreign material in the wound.

Your surgeon's recommendation to have a specialist in colorectal surgery examine your wound is a prudent step. These specialists are trained to handle complex cases involving the rectum and surrounding tissues, and they can provide a more thorough evaluation of your situation. They may perform imaging studies or additional diagnostic procedures to determine if there is indeed any residual tissue or infection that needs to be addressed.

Regarding your question about the healing process, the rate at which a fistula heals can vary significantly based on several factors, including the size and location of the fistula, the presence of infection, your overall health, and whether you have any underlying conditions such as diabetes that could impede healing. Generally, healing can take weeks to months, and in some cases, it may require multiple interventions before complete closure is achieved.

In terms of care for your wound, it is essential to follow your surgeon's instructions closely. The use of cotton swabs to disrupt the healing process at the surface of the wound is a technique that some surgeons employ to encourage drainage and prevent premature closure, which can trap infection inside. However, this should always be done under the guidance of a healthcare professional to avoid complications.

Here are some additional tips for managing your recovery:
1. Follow-Up Appointments: Keep all scheduled follow-up appointments with your surgeon or specialist. Regular monitoring is crucial for assessing the healing process and making necessary adjustments to your treatment plan.

2. Wound Care: Continue to follow the wound care instructions provided by your healthcare team. This may include keeping the area clean and dry, changing dressings as advised, and watching for signs of infection such as increased redness, swelling, or discharge.

3. Diet and Nutrition: Eating a balanced diet rich in vitamins and minerals can support healing. Focus on protein-rich foods, as protein is essential for tissue repair. Foods high in vitamin C, zinc, and other nutrients can also be beneficial.

4. Avoid Strain: If possible, avoid activities that put strain on the area around the fistula. This can help prevent further complications and allow your body to focus on healing.

5. Pain Management: If you experience pain, discuss it with your healthcare provider. They can recommend appropriate pain management strategies to help you feel more comfortable during the healing process.

6. Mental Health: Dealing with a slow recovery can be emotionally taxing. Consider seeking support from friends, family, or mental health professionals if you feel overwhelmed.

In summary, while it is understandable to feel anxious about your healing process, working closely with your healthcare team and following their recommendations will be key to achieving the best possible outcome. Don’t hesitate to ask questions and express your concerns during your appointments; open communication with your healthcare providers is vital for effective treatment.

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