Post-Surgery Concerns: Managing Issues After Hemorrhoid Surgery

Postoperative Issues After Hemorrhoid Surgery

Hello, Dr.
Ko.
After my hemorrhoid surgery, I initially developed a small granulation tissue, but the doctor told me that it would gradually subside with sitz baths.
I have already had my stitches removed, and now it has been almost a month since the surgery.
However, the granulation tissue has not decreased or resolved on its own.
Additionally, I noticed that a stitch has come out during my shower, and the end appears to have no thread.
How should I handle this situation? Can I remove it myself, or should I leave it alone as it may absorb on its own? Thank you for taking the time to answer my questions.

Xiao Hong, 20~29 year old female. Ask Date: 2018/05/12

Dr. Ke Fangxu reply Surgery

After hemorrhoid surgery, the sutures typically fall out on their own.
If they are pulled, it may cause bleeding.
If they do not fall out after a while, you can ask your doctor to trim the granulation tissue during an outpatient visit.
It is also advisable to monitor the situation for 2-3 months.

Reply Date: 2018/05/12

More Info

After undergoing hemorrhoid surgery, it's not uncommon for patients to experience concerns regarding healing and any unexpected developments, such as the appearance of small growths (often referred to as skin tags or granulation tissue) and issues with sutures. Let's address your concerns step by step.

1. Granulation Tissue
Granulation tissue can form as part of the healing process after surgery. It is typically a sign that your body is healing, but it can sometimes be mistaken for abnormal growths. In many cases, this tissue will gradually shrink and resolve on its own, especially with proper care such as sitz baths, which you mentioned. However, if the granulation tissue has not diminished after a month, it may be worth discussing with your surgeon. Sometimes, persistent granulation tissue may require treatment, such as cauterization or other minor procedures, to promote healing.

2. Suture Concerns
Regarding the suture that has emerged, it’s important to understand that some sutures used in surgery are designed to dissolve over time, while others may need to be removed manually. If you notice a suture protruding without a visible knot, it could be a dissolvable suture that is in the process of breaking down. However, if it appears to be causing discomfort or if you have any concerns about it, you should not attempt to remove it yourself. Self-removal can lead to complications such as infection or improper healing. Instead, it’s best to consult your surgeon or healthcare provider. They can assess whether the suture needs to be removed or if it will dissolve on its own.

3. When to Seek Medical Attention
If you experience any of the following symptoms, you should seek medical attention promptly:
- Increased pain or discomfort at the surgical site.

- Signs of infection, such as redness, swelling, warmth, or discharge.

- Fever or chills.

- Any unusual changes in bowel habits or bleeding.

4. Post-Surgery Care
In the meantime, continue to follow your post-operative care instructions:
- Sitz Baths: Regular sitz baths can help soothe the area and promote healing.

- Diet: Maintain a high-fiber diet to prevent constipation, which can strain the surgical site.

- Hydration: Drink plenty of fluids to aid digestion and bowel movements.

- Avoid Straining: Be cautious during bowel movements to avoid straining, which can disrupt healing.

5. Follow-Up Appointments
It’s crucial to attend any scheduled follow-up appointments with your surgeon. These visits are essential for monitoring your recovery and addressing any concerns you may have. Your surgeon can provide tailored advice based on your specific situation and the progress of your healing.

Conclusion
In summary, while the presence of granulation tissue and a protruding suture can be concerning, they are not uncommon after hemorrhoid surgery. It is essential to communicate openly with your healthcare provider about these issues. They can offer reassurance, evaluate your healing process, and determine the best course of action. Remember, your recovery is a process, and it’s important to give your body the time it needs to heal properly.

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