Post-Surgery Concerns: Managing Wound Issues After Anal Fistula Surgery

Postoperative Wound Issues After Anal Fistula Surgery

Hello Doctor, two days ago I underwent a fistulotomy.
After resting at home for two days, I noticed some yellow discharge from the wound when I took a photo with my phone today.
Is this a normal occurrence? Additionally, I have been taking warm sitz baths.
Should I rinse off any stool with a handheld shower before taking the sitz bath, or can I go directly to the sitz bath? It feels quite unclean otherwise.
Lastly, what is the recurrence rate for anal fistulas? Mine is a simple type.
Thank you, Doctor.

Niming, 20~29 year old female. Ask Date: 2021/01/20

Dr. Ke Fangxu reply Surgery

"The yellow substance in the wound" appears to be an unhealed area that is not red, swollen, hot, or painful, which can be considered normal.
After a bowel movement, it is acceptable to rinse and then take a sitz bath.
There is indeed a risk of recurrence with anal fistulas.
If there are any discomforting symptoms post-surgery, it is important to consult the surgeon for evaluation.
However, compared to "the yellow substance in the wound," if there are still sutures present, it is necessary to return for a follow-up appointment to determine if the sutures need to be removed.

Reply Date: 2021/01/20

More Info

After undergoing anal fistula surgery, it's common to have concerns about wound healing and the appearance of the surgical site. Based on your description and the image you provided, the yellow discharge you are observing may be a sign of normal healing, particularly if it is not accompanied by significant pain, redness, or an unpleasant odor. This yellowish fluid could be a mixture of serum and some necrotic tissue, which is typical in the healing process. However, it is essential to monitor the wound closely for any signs of infection, such as increased redness, swelling, or pus that has a foul smell.

Regarding your question about post-bowel movement hygiene, it is advisable to rinse the area with a handheld showerhead or gentle water flow to remove any fecal matter before proceeding with a sitz bath. This practice helps maintain cleanliness and reduces the risk of introducing bacteria into the surgical site, which could lead to infection. After rinsing, you can then soak in warm water for about 10-15 minutes, which can help alleviate discomfort and promote healing by increasing blood flow to the area.

As for the recurrence rate of anal fistulas, it can vary depending on several factors, including the complexity of the fistula, the surgical technique used, and individual patient factors such as underlying conditions (e.g., Crohn's disease). Simple anal fistulas generally have a lower recurrence rate compared to complex ones. Studies suggest that the recurrence rate for simple anal fistulas can be as low as 5-10% when treated appropriately. However, it is crucial to follow up with your surgeon for regular check-ups to monitor the healing process and address any concerns promptly.

In summary, while some yellow discharge can be normal, it is essential to keep an eye on the wound for any signs of infection. Proper hygiene after bowel movements is crucial, and rinsing the area before sitz baths is recommended. Lastly, the recurrence rate for simple anal fistulas is relatively low, but ongoing follow-up care is vital to ensure successful healing and to address any potential complications early on. If you have any further concerns or if the discharge changes in character, do not hesitate to contact your healthcare provider for further evaluation.

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