Post-Surgery Concerns: Issues with Stitches After Fistula Procedure

One week after the fistula surgery, there is a phenomenon of suture detachment at both the upper and lower ends?

Last week, my mother underwent a fistula surgery.
On the third day post-operation, I noticed that the wound seemed to be longer.
After comparing photos, I found that the upper sutures had ruptured, but I couldn't see any sutures hanging down.
A week later, I discovered that the sutures near the anal area at the lower end had also come loose, with a long piece hanging at the anal opening.
Today, my mother had a follow-up appointment, but I am unsure if the lower sutures had already fallen out during her visit.
My mother mentioned that she asked the doctor about the situation with the upper sutures, and the doctor only advised her to soak in warm water.
1.
Should we urgently return to the doctor for the management of the ruptured sutures?
2.
Is it safe for me to trim the hanging sutures for my mother?
3.
What adverse effects could result from the ruptured sutures?

Tu Mei, 40~49 year old female. Ask Date: 2019/10/23

Dr. Ke Fangxu reply Surgery

1.
The fistula surgery uses absorbable sutures that will naturally dissolve and fall off within 1-2 weeks after the procedure, so there is no need to rush to have a doctor address it.

2.
If the sutures do not fall off on their own, it is acceptable to cut them, but care should be taken not to cut the wound itself.

3.
There is no issue, but if accidentally pulled, there may be some pain.
It is also fine to keep it clean and wait for it to fall off on its own.

Reply Date: 2019/10/23

More Info

After a fistula surgery, it is not uncommon for patients to experience concerns regarding the stitches or sutures used during the procedure. Your mother's situation, where the stitches appear to have come undone or are hanging, raises several important considerations that need to be addressed promptly.

1. Need for Follow-Up Appointment: If the stitches have indeed come undone, it is crucial to consult with the surgeon or healthcare provider as soon as possible. Stitches are meant to hold the tissue together while it heals, and if they fail, it can lead to complications such as delayed healing, increased risk of infection, or even the reopening of the surgical site. The surgeon may need to assess the wound to determine if additional sutures are necessary or if the healing process is still on track. Therefore, I recommend that you arrange for your mother to see her doctor at the earliest opportunity.

2. Trimming the Hanging Sutures: It is generally not advisable for a non-medical professional to trim or manipulate any sutures. While it may seem harmless to cut the hanging suture, doing so could potentially lead to further complications, such as introducing bacteria into the wound or causing additional tearing of the tissue. If the suture is causing discomfort or irritation, it is best to have a healthcare professional evaluate it and decide on the appropriate course of action.

3. Potential Complications from Suture Failure: The failure of stitches can lead to several adverse outcomes. If the wound is not properly closed, it may not heal correctly, which can result in a larger scar or the formation of a keloid. Additionally, an open wound is more susceptible to infection, which can complicate recovery and may require further medical intervention, such as antibiotics or additional surgery. In some cases, if the fistula is not healing properly, it may necessitate further surgical procedures to correct the issue.

In summary, your mother's situation with the stitches after her fistula surgery is concerning and warrants immediate attention from her healthcare provider. It is essential to ensure that the surgical site is healing properly and to address any complications that may arise from the stitches coming undone. Encourage your mother to communicate openly with her doctor about her symptoms and any concerns she has regarding her recovery. Proper follow-up care is vital to ensure a smooth healing process and to prevent any long-term complications.

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