Post-Hemorrhoid Surgery: Managing Complications and Recovery Concerns

Post-hemorrhoid surgery?

Hello, doctor.
I would like to ask you a few questions.
I had hemorrhoid surgery a few days ago using a tissue coagulator and was discharged after two days of hospitalization.
However, on the day after discharge, I noticed that the wound seemed to have opened up, possibly due to my movements or straining while using the restroom.
During my hospital stay and on the first day after discharge, I experienced minimal pain, but on the second day, sitting on a chair caused unbearable pain, and using the restroom was excruciating to the point where I could hardly walk.
Even wiping after a bowel movement caused significant pain.
That night, I asked my husband to help apply medication and take pictures.
While applying the medication, one of the stitches came off directly from the tissue, even though the knot was still intact, and the photos clearly showed that the wound had enlarged.
The next day, I saw the doctor, who said that the stitch had fallen out and that the wound had not split open.
I would like to ask the doctor:
1.
Is it possible for a stitch to come out without the knot being opened?
2.
If the wound were to split open, would it need to be re-stitched, or could it heal naturally?
3.
The doctor advised against applying medication since I just had surgery, but due to the wound opening, my husband applied iodine.
Is this acceptable? Should I apply iodine after soaking in a sitz bath?
4.
I have noticed a slight discharge of pus from the wound in the past few days.
Is this normal?
5.
Yesterday, I noticed that the wound seemed to be swollen, but it is already the fourth day post-surgery.
It was not swollen in the first three days.
Is this swelling on the fourth day normal?
6.
Initially, my anus looked very neat and smooth after the surgery, but now, due to the stitch falling out, there is a protrusion of tissue.
Will this increase the likelihood of hemorrhoid recurrence in the future?
Thank you for your assistance.

Miss Hu, 20~29 year old female. Ask Date: 2021/04/11

Dr. Yu Mingchang reply Surgery

Please come back for a follow-up appointment.
The stitches will dissolve on their own.

Reply Date: 2021/04/11

More Info

Post-hemorrhoid surgery recovery can be challenging, and it’s not uncommon for patients to experience complications or concerns during the healing process. Based on your description, it seems you are facing several issues following your surgery, including pain, potential wound complications, and concerns about the healing process. Let’s address your questions one by one, and I’ll provide some additional context regarding recovery after hemorrhoid surgery.

1. Suture Issues: It is indeed possible for sutures to come loose or fall out even if the knot appears intact. This can happen due to various reasons, including the tension on the suture, the type of suture material used, or the body's healing process. If the suture was not anchored properly or if there was excessive movement or strain on the area, it could lead to the suture coming out prematurely.

2. Wound Healing: If the wound has indeed opened, the approach to treatment can vary. In many cases, small openings can heal on their own, but larger or more significant openings may require re-suturing to ensure proper healing and to prevent complications such as infection or excessive scarring. Your surgeon will be the best person to assess the wound and determine the appropriate course of action.

3. Topical Treatments: It’s generally advised to avoid applying topical antiseptics like iodine on fresh surgical wounds unless specifically instructed by your surgeon. This is because such substances can irritate the tissue and potentially delay healing. If your doctor advised against applying medication, it’s best to follow that guidance unless there’s a clear indication to do otherwise.

4. Pus and Infection: The presence of a small amount of discharge or pus can be a sign of infection, especially if it is accompanied by increased redness, swelling, or pain. However, some drainage can be normal in the initial days post-surgery. It’s crucial to monitor the situation closely and report any concerning symptoms to your healthcare provider.

5. Swelling: Swelling can occur after surgery, especially around the surgical site. However, if you notice a significant increase in swelling after several days of stable recovery, it could indicate a problem, such as infection or hematoma formation. It’s advisable to consult your doctor to evaluate the swelling.

6. Risk of Recurrence: The appearance of tissue protruding from the surgical site can be concerning. While it may not directly lead to a recurrence of hemorrhoids, it could indicate that the surgical site is not healing properly. Proper follow-up care and monitoring are essential to ensure that any potential complications are addressed early.

Additional Considerations for Recovery
Post-operative care after hemorrhoid surgery is crucial for a smooth recovery. Here are some general recommendations:
- Pain Management: It’s important to manage pain effectively. Over-the-counter pain relievers or those prescribed by your doctor can help alleviate discomfort.

- Dietary Adjustments: A high-fiber diet and adequate hydration are essential to prevent constipation, which can strain the surgical site during bowel movements. Consider incorporating fruits, vegetables, and whole grains into your diet.

- Hygiene: Keeping the area clean is vital. Gentle cleansing with warm water after bowel movements can help prevent irritation. Avoid harsh soaps or scrubs.

- Activity Level: Avoid heavy lifting or strenuous activities that could strain the surgical area. Gradually increase your activity level as advised by your healthcare provider.

- Follow-Up Appointments: Regular follow-ups with your surgeon are essential to monitor healing and address any complications early.

In conclusion, while complications can arise after hemorrhoid surgery, many can be managed effectively with proper care and communication with your healthcare provider. It’s essential to stay vigilant about your symptoms and seek medical advice whenever you have concerns. Your recovery journey is important, and addressing these issues promptly can lead to better outcomes.

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