Post-Surgery Concerns: Discharge and Healing After Fistula Removal

Postoperative care for anal fistula surgery?

Hello, Doctor.
It has been 4 weeks since my fistula excision surgery.
During my follow-up appointment 2 weeks ago, the doctor said my recovery was good and that I didn't need to return for further visits.
Currently, the external wound around the anus has mostly healed, but there is still thick yellowish-green discharge and a small amount of blood-tinged fluid.
I occasionally feel discomfort inside the anus.
Yesterday, I inserted my finger and felt something resembling a scab deep at the site of the excision.
I would like to ask the doctor: 1.
Is the thick yellowish-green discharge and small amount of blood-tinged fluid a sign of a negative change in the wound? 2.
Is it normal to feel something resembling a scab deep at the site of the fistula excision? Thank you for your assistance, Doctor.

Xiao Chen, 30~39 year old female. Ask Date: 2020/05/12

Dr. Ke Fangxu reply Surgery

1.
The healing period after fistula surgery varies depending on the length of the fistula.
Generally, complete healing takes at least one month; however, more complex fistulas may take up to two months to heal.
During the healing process, there may be secretions, and it may take some time to determine if there is a recurrence of the fistula.
If the wound continues to be swollen and painful, it is important to consult the surgeon for further evaluation.
2.
The inner side of the fistula after excision will be sutured with absorbable sutures, such as catgut, to control bleeding.
Typically, these sutures will fall out within a week post-surgery.
It is normal for scar tissue to form during the healing process; however, to determine whether your condition is normal, a physical examination by a physician is necessary.

Reply Date: 2020/05/12

More Info

After undergoing a fistula removal surgery, it's common to have concerns about the healing process and any potential complications. Based on your description, you are currently four weeks post-surgery, and while the external wound appears to be healing well, you are experiencing some unusual symptoms, including thick yellowish-green discharge, slight blood, and a sensation of discomfort in the anal area. Additionally, you mentioned feeling something akin to scabbing in the deeper area where the fistula was removed.
1. Thick Yellowish-Green Discharge and Blood: The presence of thick yellowish-green discharge can be concerning, as it may indicate an infection. In a typical healing process, the discharge should gradually decrease in volume and change in color from yellowish to clear or light pink as the wound heals. A small amount of blood can be normal, especially if you are experiencing some discomfort or if the area is still sensitive. However, if the discharge is accompanied by a foul odor, increased pain, or fever, it is essential to contact your healthcare provider immediately, as these could be signs of an infection that may require treatment.

2. Scabbing in the Deeper Area: The presence of what feels like scabbing in the area where the fistula was excised can be a normal part of the healing process. After surgery, the body forms a scab as part of the natural healing mechanism, which helps protect the underlying tissue as it regenerates. However, if the scab appears excessively thick, is painful, or if you notice any changes in the surrounding skin (such as increased redness or swelling), it would be prudent to have it evaluated by your doctor.

In summary, while some discharge and discomfort can be expected after a fistula removal, the characteristics of the discharge and any accompanying symptoms are crucial in determining whether your healing process is on track or if there are complications. It is always best to err on the side of caution and consult with your healthcare provider if you have any doubts or if your symptoms worsen. They may recommend further evaluation or treatment to ensure a smooth recovery.

Additional Considerations for Post-Surgery Care:
- Hygiene: Maintain good hygiene in the anal area to prevent infections. Gently clean the area with mild soap and water, and avoid using harsh chemicals or scrubs.

- Diet: A diet high in fiber can help prevent constipation, which is crucial for avoiding strain during bowel movements that could disrupt the healing process.

- Follow-Up Appointments: Even if your doctor has indicated that you do not need to return for follow-up, it is essential to keep an open line of communication. If you notice any changes or have concerns, do not hesitate to reach out.

- Pain Management: If you are experiencing discomfort, over-the-counter pain relievers may help, but consult your doctor before taking any medication.

- Signs of Complications: Be vigilant for signs of complications such as increased pain, swelling, fever, or changes in discharge. These symptoms warrant immediate medical attention.

Overall, your recovery is a process that requires attention and care. By monitoring your symptoms and maintaining communication with your healthcare provider, you can help ensure a successful recovery from your fistula removal surgery.

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