Post-Surgery Complications: Managing Open Sutures After Fistula Repair

Dehiscence of sutures after fistula surgery?

Hello, Doctor.
After my fistula surgery, while resting at home, I noticed that some of the stitches on my wound have come apart.
During my follow-up visit, I continuously asked the doctor about the subsequent management of the wound, but the doctor advised me to take sitz baths and apply medication, and then just observe.
It has now been one month and three weeks, and the areas where the stitches have not come apart are healing well, but the area that has opened has formed a small round hole.
Every time I have a bowel movement, stool gets trapped in that hole.
I would like to know if there is still a chance for that small round hole to close up, or if I will need to undergo further surgical intervention (which specialty should I consult?).
Today, during my follow-up, my healthcare providers did not respond to my questions and just told me to observe it myself.
Additionally, my surgical wound is no longer painful, but I still have the small round hole that has opened.
Is it still necessary for me to continue sitz baths and apply ointment?

Ke Xiao Jie, 30~39 year old female. Ask Date: 2019/02/27

Dr. Ke Fangxu reply Surgery

The fistula surgery will intentionally leave a small opening to allow for delayed healing of the wound, which helps reduce the risk of recurrence.
This wound will gradually heal over a period of about one to two months.
Currently, it is important to maintain cleanliness.
Before the wound heals, sitz baths should be taken, and if discomfort occurs, topical ointments can be applied.

Reply Date: 2019/02/27

More Info

After undergoing a fistula repair surgery, it is not uncommon to experience complications such as open sutures or areas of the wound that do not heal properly. In your case, the presence of a small circular hole where the sutures have opened can be concerning, especially if it is retaining fecal matter. This situation can lead to potential complications, including infection or delayed healing.

Firstly, it is important to understand that the healing process can vary significantly from person to person. Factors such as the type of surgery performed, the individual's overall health, and adherence to post-operative care instructions can all influence recovery. In your case, since the majority of the wound has healed but a small area remains open, it is crucial to monitor this area closely.

The small circular hole you mentioned may still have the potential to close on its own, especially if it is not infected and is kept clean. However, if it continues to retain fecal matter, this could lead to irritation or infection, which would hinder the healing process. It is advisable to maintain good hygiene in the area, which may include gentle cleaning and possibly continuing with sitz baths if recommended by your healthcare provider. Sitz baths can help keep the area clean and promote healing by increasing blood flow to the region.

Regarding your question about whether further surgical intervention is necessary, it would depend on several factors. If the hole does not show signs of improvement over time, or if you notice any signs of infection (such as increased redness, swelling, or discharge), it would be prudent to seek further evaluation. In such cases, a visit to a surgeon who specializes in colorectal or general surgery would be appropriate, as they can assess the wound and determine if additional procedures, such as re-suturing or other interventions, are needed.

It is also essential to communicate effectively with your healthcare team. If you feel that your concerns are not being addressed, consider reaching out again for clarification or requesting a follow-up appointment. Sometimes, a different healthcare provider may offer a fresh perspective or additional options for managing your situation.

In summary, while the small circular hole may still have the potential to heal on its own, it is crucial to monitor it closely for any signs of infection or complications. Maintaining proper hygiene and following your healthcare provider's recommendations are key to promoting healing. If the situation does not improve or worsens, do not hesitate to seek further medical advice from a specialist. Your health and well-being are paramount, and addressing any concerns promptly can help ensure a smoother recovery process.

Similar Q&A

Post-Surgery Complications: Stitch Issues After Fistula Procedure

Dear Dr. Chang, I returned home to rest the day after my fistula surgery, but on the morning of the second day post-operation, I noticed some of the sutures had come loose (some have fallen off, while others are still attached to the wound). The area feels slightly raised to the...

Dr. Zhang Shuhao reply Surgery
Fistula surgery will use absorbable sutures, which may come loose if there is significant tension on the wound; this is normal as long as there is no excessive bleeding. No urgent intervention is required. If the suture is hanging outside, avoid pulling on it. You can carefully t...

Post-Surgery Concerns: What to Do If Your Fistula Wound Opens?

Dear Doctor, I had a fistula surgery last week, and on the seventh day post-operation, the suture at the wound site came undone and is now hanging beside the wound. My father mentioned that the wound is wide open, creating a hole. Is this a concern? I have a follow-up appointme...

Dr. Ke Fangxu reply Surgery
It is normal for the sutures to hang and for the wound to open slightly one week post-operation, as this method is designed to stop bleeding without the need for suture removal. Based on your description, the wound appears to be normal, and you can return for your follow-up appoi...

Understanding Complications After Fistula Surgery: A Patient's Journey

Hello, Dr. Hsu. I would like to ask you some questions. My family member underwent anal fistula excision surgery on July 19 under spinal anesthesia. The surgeon sutured the wound in three layers, both internally and externally. Before the surgery, I found some information suggest...

Dr. Xu Kaixi reply Surgery
The surgical approach for anal fistulas is determined preoperatively based on various factors such as complexity, depth, and the presence of associated infections or abscesses. Most simple fistulas, like the one your family member has, are treated with fistulotomy, while those wi...

Managing Exposed Sutures After Fistula Surgery: What to Do?

It has been about 23 days since my fistula surgery, and the wound is healing well without any pain. Today, while taking a sitz bath, I noticed that a suture end is protruding. The surgeon mentioned that the sutures used are absorbable. Should I cut the suture end or just leave it...

Dr. Ke Fangxu reply Surgery
Based on the photo you provided, it does appear to be surgical sutures. If you are not experiencing any discomfort, I recommend leaving it alone; it should fall out on its own within one to two weeks. However, if you are experiencing any discomfort around the anus, you should con...