Post-Surgery Concerns: Swelling and Pain After Fistula Repair

Post-fistula surgery wound swelling?

Hello! I would like to ask Dr.
Ke about my condition.
I underwent fistula surgery in mid-September, and about two weeks post-surgery, the wound had healed.
However, I experienced some swelling and pain, and after a few days, the healed wound developed a small opening that bled and discharged some fluid.
I have been attending follow-up appointments, and the doctor mentioned that the internal opening has healed, and we should continue to monitor it.
Recently, during this week's follow-up, the previously opened wound has healed again, but it is still swollen, and applying pressure causes a sharp pain.
After the appointment, the doctor prescribed antibiotics for me to take for a week and to return for another check-up.
When I examine the swollen area, it feels hard around the edges and soft in the center.
I would like to know if this indicates a recurrence of the fistula.

Jia, 30~39 year old female. Ask Date: 2018/10/24

Dr. Ke Fangxu reply Surgery

Based on your description, it seems more like a recurrence.
We can start with antibiotic treatment to see if it helps.
If the treatment is ineffective or if there are repeated episodes, it may be necessary to undergo surgery again.

Reply Date: 2018/10/24

More Info

After undergoing a fistula repair surgery, it is not uncommon to experience swelling and pain during the recovery process. Your concerns regarding the healing of the surgical site, the presence of a small opening, and the sensations you are experiencing are valid and warrant careful consideration.

Firstly, it is important to understand that post-surgical swelling and pain can be attributed to several factors. After any surgical procedure, the body initiates a healing response, which includes inflammation. This inflammation can lead to swelling, tenderness, and discomfort around the surgical site. In your case, the fact that the wound initially healed but then developed a small opening suggests that there may have been some complications during the healing process.
The presence of a small hole that leaked blood and discharge could indicate that the healing process was not entirely straightforward. It is possible that the wound may have become infected or that there was some tension on the sutures that caused them to break down prematurely. The fact that your doctor has prescribed antibiotics indicates that they are taking the possibility of infection seriously, which is a common precaution in such cases.

Regarding your question about whether the symptoms you are experiencing could indicate a recurrence of the fistula, it is essential to consider the characteristics of the swelling and pain. If the swelling is localized and associated with tenderness, it may simply be a part of the normal healing process. However, if you notice increased redness, warmth, or a significant increase in pain, these could be signs of infection or complications that may require further intervention.

The hardness you feel around the surgical site could be due to scar tissue formation, which is a normal part of the healing process. Scar tissue can sometimes feel firm or hard compared to the surrounding tissue. The soft area in the middle may indicate fluid accumulation or a seroma, which is a collection of fluid that can occur after surgery.
It is crucial to follow up with your surgeon as advised. They will be able to assess the wound more thoroughly, possibly through physical examination or imaging if necessary, to determine the exact cause of your symptoms. They can also provide guidance on how to care for the wound and manage any discomfort you may be experiencing.

In summary, while some swelling and pain are expected after fistula repair surgery, the presence of a reopened wound and ongoing discomfort should be closely monitored. It is essential to adhere to your doctor's recommendations, including taking prescribed antibiotics and attending follow-up appointments. If you have any concerns about the healing process or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation. Your recovery is a priority, and open communication with your medical team is vital to ensure the best possible outcome.

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