Post-Surgery Concerns: Anal Fistula Wound Issues

Postoperative wound issues after anal fistula surgery?

1.
I'm sorry, doctor.
I feel that I may not have expressed my concerns clearly during my last visit.
I am providing a photo of my discharge for your reference: https://drive.google.com/file/d/1npjn2MuEsOAoZh3qwvAvKpzP8S1Zv5qn/view?usp=drivesdk.
It is a thick, yellow-green, pus-like discharge (similar to mucus), but I'm not sure if it is pus.
When I returned for follow-up, the doctors said my wound was healing normally, and when I asked questions, they said it was part of the normal healing process.
However, I still feel uneasy.
Although the discharge has decreased, the color and consistency have changed.
Could you please tell me if this is pus? Is it normal to have pus from an anal wound? Does this indicate a recurrence?
2.
Also, what are those red areas on my wound? Are they spots where the skin hasn't healed properly, or something else? Initially, there were no such areas, but they appeared gradually.
Here is the initial wound: https://drive.google.com/file/d/1nqk3fokT_96L8R6p9CHeVmzRg-aHgum0/view?usp=drivesdk, and here is the current wound: https://drive.google.com/file/d/1noTzGT9rHhapbJ6PHKUpIe6i_L0_r2_F/view?usp=drivesdk.
3.
I noticed when taking the photos that the stitches are still present.
I remember the nurse telling me that they would fall out naturally.
Is it normal for them to take this long? (Previously, a small piece of thread came out, but nothing since then.) Thank you, doctor, for addressing my concerns.
The surgeon only mentioned that everything was normal, which has made me a bit worried, so I had to seek help online.
I am being treated at the colorectal surgery department of Far Eastern Memorial Hospital.

Niming, 20~29 year old female. Ask Date: 2021/02/05

Dr. Ke Fangxu reply Surgery

1.
It's difficult to assess just by looking at the photo, but if the wound appears as shown in your picture, it should just be normal exudate.
2.
The redness indicates that granulation tissue is beginning to form, which is a normal part of the wound healing process.
3.
Different types of sutures have varying absorption and shedding times; if they have not fallen out after a month, you may ask your physician to remove them.

Reply Date: 2021/02/05

More Info

Post-surgery concerns, especially regarding anal fistula wounds, can be quite distressing. It's important to understand the healing process and what signs to look for in order to ensure proper recovery. Let's address your questions one by one.

1. Discharge Characteristics: The yellow-green, thick, mucus-like discharge you described could be indicative of pus, especially if it has changed in consistency and color. While some discharge can be normal during the healing process, particularly in the case of surgical wounds, the presence of thick, discolored discharge may suggest an infection. It's crucial to monitor this closely. If the discharge continues to be thick, changes color, or is accompanied by increased pain, swelling, or fever, it would be wise to consult your healthcare provider again. They may consider further evaluation or treatment, such as antibiotics, if an infection is suspected.

2. Red Areas Around the Wound: The red areas you are observing around the wound could be a sign of inflammation, which is a normal part of the healing process. However, if these areas are increasing in size, becoming more painful, or if there is a significant change in the discharge, it could indicate that the wound is not healing properly or that there is an underlying infection. It's essential to keep the area clean and dry, and to follow any post-operative care instructions provided by your surgeon.

3. Suture Concerns: Regarding the sutures, it is common for absorbable sutures to take some time to dissolve completely. Depending on the type of sutures used, they may remain in place for several weeks before they dissolve or fall out on their own. If you notice that the sutures are still intact after a significant amount of time and you have concerns about them, it would be advisable to follow up with your surgeon. They can assess whether the sutures are still necessary or if they should be removed.

In summary, while some discharge and redness can be normal during the healing process, changes in the characteristics of the discharge or the appearance of the wound should be taken seriously. It is always better to err on the side of caution and consult your healthcare provider if you have any concerns. They can provide you with the most accurate assessment and ensure that your recovery is on track.
Additionally, maintaining good hygiene, following post-operative care instructions, and attending follow-up appointments are crucial for a successful recovery. If you feel that your concerns are not being adequately addressed during your appointments, do not hesitate to seek a second opinion or ask for a more thorough explanation from your healthcare provider. Your health and peace of mind are paramount.

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