Management of granulation tissue after hemorrhoid surgery?
Hello Dr.
Ke! My wife underwent a stage IV hemorrhoid surgery at the end of April.
A week later, during her follow-up visit, a small granulation tissue was observed.
The doctor mentioned that the granulation tissue would gradually disappear or shrink and did not perform any treatment.
It has now been two weeks since the last follow-up, and the size of the granulation tissue has not changed, nor is there any discharge.
I have read some articles where some doctors believe that if there is no discomfort, it can be left alone, while others may remove it due to aesthetic concerns or worries that the granulation tissue might impede wound healing.
I would like to ask Dr.
Ke: Is it true that there will be no issues in the future if there is currently no discomfort? Under what circumstances could granulation tissue hinder wound healing? Does granulation tissue require special care? Is the recovery process after scraping off the granulation tissue similar to that of hemorrhoid surgery? Thank you for taking the time to respond!
Mr. Shi, 60~69 year old female. Ask Date: 2019/05/22
Dr. Ke Fangxu reply Surgery
1.
No.
2.
Nor will it.
3.
Not necessary.
4.
If it is just the removal of granulation tissue, it can usually be performed as an outpatient procedure under local anesthesia.
Reply Date: 2019/05/22
More Info
After hemorrhoid surgery, the presence of granulation tissue is a common occurrence. Granulation tissue is a normal part of the healing process, consisting of new connective tissue and tiny blood vessels that form on the surface of a wound. It typically appears as a small, raised, red or pink area at the surgical site. In your wife's case, the granulation tissue that developed after her surgery is not unusual, especially considering that she underwent a significant procedure.
Understanding Granulation Tissue
Granulation tissue serves several important functions in the healing process. It helps to protect the wound, provides a scaffold for new tissue growth, and facilitates the healing of the underlying structures. In most cases, granulation tissue will gradually shrink and disappear as the wound heals. However, the timeline for this process can vary significantly from person to person, depending on factors such as the individual's overall health, the extent of the surgery, and how well the body responds to healing.
When to Be Concerned
In general, if the granulation tissue is not causing any discomfort, pain, or other symptoms, it is usually not a cause for concern. However, there are certain situations where granulation tissue might interfere with healing:
1. Excessive Growth: If the granulation tissue grows excessively, it can form what is known as "proud flesh," which may protrude above the level of the surrounding skin and potentially impede the healing of the wound.
2. Infection: If there are signs of infection, such as increased redness, swelling, warmth, or discharge from the area, it is important to seek medical attention. Infections can complicate the healing process and may require treatment.
3. Interference with Function: If the granulation tissue begins to interfere with normal bodily functions or causes discomfort, it may need to be addressed.
Management and Care
In terms of management, granulation tissue typically does not require special care beyond maintaining good hygiene. Keeping the area clean and dry is essential. If the granulation tissue does not change in size or appearance over time, or if it becomes bothersome, your healthcare provider may consider options for removal. This can often be done in a simple outpatient procedure, and the recovery process is usually similar to that of the initial surgery.
Recovery Process
The recovery process after the removal of granulation tissue is generally straightforward. Patients can expect some minor discomfort, but it is typically manageable with over-the-counter pain relief. The healing time can vary, but most individuals return to their normal activities relatively quickly.
Conclusion
In summary, if your wife is not experiencing any discomfort or complications from the granulation tissue, it is likely safe to monitor the situation. However, if there are any changes in symptoms or if the granulation tissue becomes bothersome, it would be prudent to consult with her healthcare provider for further evaluation and potential treatment options. Regular follow-up appointments are important to ensure that the healing process is progressing as expected and to address any concerns that may arise.
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