Recovery Time After Anal Abscess or Fistula Surgery

Please ask questions regarding anal abscess or fistula surgery?

Hello Dr.
Ke: I underwent an excision of internal and external hemorrhoids in January of last year.
At that time, two larger wounds were formed; one side healed well, but the other side has not healed properly and has continued to swell.
After such a long time, it has developed into an anal abscess or possibly a fistula—I'm not sure.
The doctor mentioned it was initially a small abscess that needed drainage, but I was unable to address it immediately, which has led to some signs of a fistula.
The granulation tissue is about 0.2 cm, and it occasionally becomes swollen and painful, with yellow-green pus and a foul odor.
The doctor has scheduled me for surgery on November 6.
I would like to ask Dr.
Ke, based on my description, how long the healing time after surgery might be? My job involves prolonged standing or sitting with occasional walking, but I do not need to lift heavy objects.
How many days of leave should I plan to take after the surgery? Is one month sufficient? I really need your advice on this matter.
Thank you, Dr.
Ke.

Junyou, 30~39 year old female. Ask Date: 2019/10/06

Dr. Ke Fangxu reply Surgery

If the anal fistula is not of the complex type, it can fully heal within a month after surgery.
Pain typically alleviates significantly after about a week of rest.
Taking about two weeks off work may be sufficient.
However, if the fistula is longer or has multiple openings, the recovery time will be extended accordingly.

Reply Date: 2019/10/06

More Info

After undergoing surgery for an anal abscess or fistula, the recovery time can vary significantly based on several factors, including the extent of the surgery, the individual’s overall health, and the specific characteristics of the abscess or fistula. In your case, it appears that you have developed a more complex situation with a potential fistula following the initial surgery for hemorrhoids, which can complicate recovery.

Typically, after surgery for an anal abscess or fistula, patients can expect a recovery period that ranges from a few weeks to several months. The initial healing of the surgical site may take about 2 to 4 weeks, but complete healing, especially if a fistula is involved, can take longer. In your situation, since you mentioned that the area has developed into a fistula and is still producing pus, it is crucial to address this surgically to prevent further complications.

Regarding your specific questions:
1. Healing Time: After the surgery scheduled for November 6, the initial healing of the surgical site may take around 2 to 4 weeks. However, if the surgery involves more complex procedures to address the fistula, complete healing could take several weeks to months. It is essential to follow your surgeon's post-operative care instructions closely, as this can significantly influence your recovery time.

2. Time Off Work: Given the nature of your job, which involves prolonged standing or sitting, you may need to take some time off to ensure proper healing. Generally, patients are advised to take at least 1 to 2 weeks off work after such surgeries. However, since your work does not involve heavy lifting, you might be able to return sooner, depending on how you feel and your surgeon's advice. A month off should be more than sufficient for recovery, but it is essential to listen to your body and not rush back into your routine if you are still experiencing pain or discomfort.

3. Post-operative Care: After surgery, it is crucial to maintain good hygiene in the anal area to prevent infection. You may be advised to take sitz baths, keep the area clean and dry, and possibly use prescribed medications to manage pain and prevent infection. Regular follow-up appointments with your surgeon will be necessary to monitor the healing process and address any concerns that may arise.

4. Signs of Complications: Be vigilant for any signs of complications, such as increased pain, swelling, fever, or changes in the discharge from the surgical site. If you notice any of these symptoms, it is essential to contact your healthcare provider promptly.

In summary, while the initial healing after surgery for an anal abscess or fistula may take a few weeks, complete recovery can take longer, especially if complications are present. Taking adequate time off work and following post-operative care instructions will be vital for a successful recovery. Always consult with your surgeon for personalized advice tailored to your specific situation.

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