Post-Surgery Concerns: Is Pain and Wound Opening Normal After Fistula Surgery?

Post-fistula surgery

After undergoing anal fistula surgery on July 7, I returned home to rest.
Yesterday, after riding a motorcycle, I experienced anal pain, and today I noticed that the surgical stitches (which are black and non-absorbable) are intact, but the tissue has split open.
Since my follow-up appointment is not yet due, I would like to know if this is normal or if I should return for an earlier consultation.

Li Zi, 40~49 year old female. Ask Date: 2020/07/13

Dr. Ke Fangxu reply Surgery

Anal fistula surgery typically uses absorbable sutures for wound closure.
It is normal to experience pain for 1-2 weeks post-surgery.
Without visual access to the wound, it is difficult to determine if there is a true opening.
However, if there are any concerns, it is best to have the surgeon examine it for reassurance.

Reply Date: 2020/07/13

More Info

After undergoing fistula surgery, experiencing pain and noticing changes in your surgical site can be concerning. It is not uncommon for patients to have some discomfort and swelling in the area post-surgery, especially within the first few weeks. However, the specific symptoms you are describing—pain in the anal area after riding a motorcycle and the appearance of a wound opening—warrant careful consideration.

Firstly, pain following fistula surgery can be expected as the body heals. The anal region is sensitive, and activities that involve movement or pressure, such as riding a motorcycle, can exacerbate discomfort. It is essential to listen to your body; if the pain is significant or worsening, this could indicate that something is not right.

Regarding the wound opening you mentioned, it is crucial to assess the extent of this issue. If the incision site appears to be splitting or if there is any discharge, increased redness, or swelling, these could be signs of complications such as infection or improper healing. Non-absorbable sutures, like the black ones you mentioned, are typically used to ensure that the wound stays closed during the initial healing phase. If the tissue around the sutures is separating, this could lead to a delayed healing process or even the formation of a new fistula.

In general, if you notice any of the following symptoms, it is advisable to seek medical attention promptly:
1. Increased Pain: If the pain escalates or becomes unbearable, it is a sign that you should consult your healthcare provider.

2. Wound Changes: Any visible changes in the wound, such as opening, discharge, or unusual swelling, should be evaluated by a physician.

3. Fever or Chills: These could indicate an infection, which requires immediate medical intervention.

4. Persistent Symptoms: If symptoms do not improve or worsen over time, it is essential to follow up with your surgeon.

In terms of recovery and rehabilitation, here are some general recommendations that may help alleviate discomfort and promote healing:
- Rest: Avoid activities that put pressure on the surgical site, such as riding a motorcycle or heavy lifting, until you have fully healed.

- Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain. However, consult your doctor before taking any medication.

- Hygiene: Keep the area clean and dry. Gentle cleansing with mild soap and water can help prevent infection.

- Diet: A high-fiber diet can help prevent constipation, which can strain the surgical site during bowel movements. Staying hydrated is also essential.

- Follow-Up Appointments: Attend all scheduled follow-up appointments with your surgeon to monitor healing and address any concerns.

In conclusion, while some pain and discomfort are normal after fistula surgery, the specific symptoms you are experiencing—especially the wound opening—should not be ignored. It is advisable to contact your healthcare provider for an evaluation before your scheduled follow-up appointment. Early intervention can prevent complications and ensure a smoother recovery process.

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