Post-Surgery Concerns: Healing Process After Anal Fistula Surgery - Surgery

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Post-anal fistula surgery


Hello, Doctor: I had anal fistula surgery on March 15, and it has been over a month since the operation.
There is still a small opening on the surface of the wound that has not healed, and it currently secretes a little yellowish fluid.
Today, I had more bowel movements than usual, and there is noticeable swelling around the wound, which is uncomfortable to the touch, and the wound also secretes blood-tinged fluid.
I would like to ask if it is normal for the wound to still have a small opening that has not healed by now?

Xiao Yu, 20~29 year old female. Ask Date: 2020/04/21

Dr. Ke Fangxu reply Surgery


After anal fistula surgery, the wound should be completely healed within one month.
If the initial wound was larger, it may take a few more weeks to heal.
The biggest concern is the potential recurrence of the fistula after surgery, which would require another surgical procedure.
It is recommended to perform warm sitz baths and monitor the situation for a few weeks.
If the condition persists beyond two months, the likelihood of fistula recurrence is quite high.
It is best to consult with the original surgeon to discuss the subsequent treatment plan.

Reply Date: 2020/04/21

More Info


After undergoing anal fistula surgery, it is common to have concerns about the healing process, especially when there are visible signs such as a small unhealed area, discharge, and swelling. Based on your description, it appears that you are experiencing some typical post-operative symptoms, but there are also some aspects that warrant closer attention.

Firstly, it is not unusual for the surgical site to have a small opening or "hole" that has not yet fully healed, especially within the first few weeks to a month after surgery. The healing process for anal fistulas can be quite variable, depending on several factors, including the complexity of the fistula, the surgical technique used, and individual patient factors such as overall health and adherence to post-operative care instructions.

The presence of yellowish discharge can be a sign of normal healing, as the body often produces fluid to help clean the wound. However, if the discharge has a foul odor or is accompanied by increased redness, warmth, or significant swelling, these could be signs of infection. It is essential to monitor these symptoms closely. The swelling you are experiencing, particularly if it is painful upon pressure, could also indicate inflammation or a possible complication such as an abscess.

Regarding the bleeding you mentioned, some minor bleeding can occur after surgery, especially if the area is irritated or if you have had a bowel movement. However, if the bleeding is significant or persistent, it is crucial to seek medical attention.
In terms of the healing timeline, while some patients may see significant improvement within a month, others may take longer, especially if the fistula was complex or if there were any complications during surgery. It is generally expected that the majority of the healing will occur within the first few months, but complete healing can sometimes take longer.

Given your symptoms, it is advisable to consult with your surgeon or healthcare provider sooner rather than later, especially since you are experiencing discomfort, swelling, and discharge. They may want to perform a physical examination to assess the surgical site and determine if any further intervention is necessary.
In conclusion, while some aspects of your healing process may be normal, it is essential to remain vigilant for signs of infection or complications. Regular follow-ups with your healthcare provider are crucial to ensure that your recovery is on track and to address any concerns that may arise during the healing process. If you feel that your symptoms are worsening or if you have any doubts, do not hesitate to seek medical advice promptly. Your health and comfort are paramount, and timely intervention can help prevent more significant issues down the line.

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