Post-Surgery Complications: What to Do If Your Stitch Falls Out

The stitches from the anal prolapse surgery have come loose after the excision?

On October 2nd, I underwent surgery for hemorrhoidectomy.
According to the doctor's instructions, I have been taking sitz baths in the morning and evening after bowel movements.
However, on October 9th, I noticed that the suture had come undone, and there seemed to be a tendency for the incision to split open.
I just returned from the emergency department, where it was confirmed that the wound has some necrosis.
The medical staff advised me to take diligent care at home.
I would like to know if this situation could lead to the possibility of needing to be sutured again.

Xiao Xiaojie, 20~29 year old female. Ask Date: 2020/10/10

Dr. Xu Kaixi reply Surgery

The surgery you underwent is likely a hemorrhoidectomy.
The surgical wound at the anal area may potentially reopen due to straining during bowel movements or external forces.
Unless there is significant bleeding, it typically does not require re-suturing; regular dressing changes to keep the wound clean are sufficient.
The wound will gradually heal over time.

Reply Date: 2020/10/10

More Info

After undergoing surgery for hemorrhoidectomy on October 2nd, it is concerning to hear that you have experienced complications with your stitches, particularly with the stitch falling out and signs of wound dehiscence (the wound opening up). This situation can be distressing, but it is essential to understand the potential implications and the steps you can take to manage your recovery effectively.

Firstly, it is not uncommon for surgical wounds, especially in delicate areas like the anal region, to experience complications such as infection or dehiscence. Factors that can contribute to these issues include inadequate wound care, infection, excessive tension on the stitches, or underlying health conditions that may impair healing, such as diabetes or smoking.

Given that you have already been advised to maintain diligent care of the wound, it is crucial to follow those instructions closely. Here are some steps you can take to promote healing and potentially avoid the need for re-suturing:
1. Wound Care: Ensure that you are keeping the area clean and dry. Follow your doctor's instructions regarding sitz baths, which can help soothe the area and promote cleanliness. After bathing, gently pat the area dry with a clean towel.

2. Avoid Strain: It is vital to avoid straining during bowel movements. If you are experiencing constipation, consider dietary changes to include more fiber, stay hydrated, and possibly use stool softeners as recommended by your healthcare provider.

3. Monitor for Infection: Keep an eye on the wound for any signs of infection, such as increased redness, swelling, warmth, or discharge. If you notice any of these symptoms, contact your healthcare provider immediately.

4. Follow-Up Appointments: Attend all scheduled follow-up appointments with your surgeon. They will assess the healing process and determine if further intervention, such as re-suturing, is necessary. If the wound is not healing properly, your doctor may decide to re-suture it to facilitate better healing.

5. Pain Management: If you are experiencing significant pain, discuss pain management options with your healthcare provider. Proper pain control can help you avoid tension on the surgical site, which may contribute to further complications.

6. Lifestyle Adjustments: Consider lifestyle changes that promote healing, such as avoiding heavy lifting and strenuous activities until you have fully recovered.
Regarding the possibility of needing to re-suture the wound, it is indeed a potential outcome if the wound does not heal adequately on its own. Your healthcare provider will evaluate the wound's condition and make a recommendation based on their assessment. If the wound has significant dehiscence or signs of infection, they may opt for re-suturing to ensure proper healing and prevent further complications.

In summary, while the situation you are facing is concerning, there are proactive steps you can take to manage your recovery. Maintain diligent wound care, monitor for signs of infection, and keep open communication with your healthcare provider. They are best equipped to assess your situation and guide you through the healing process. If re-suturing becomes necessary, it is typically a straightforward procedure, and your healthcare team will ensure that you receive the appropriate care to facilitate a successful recovery.

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