Post-Surgery Care for Anal Fistula: Medication Application Tips

Post-operative care for fistula includes applying medication?

Hello, doctor.
I had an anal fistula surgery at the clinic a week ago.
During my follow-up visit today, the surgeon demonstrated how to apply the ointment evenly with my fingertip, inserting it about two fingers deep, and pressing on the recessed area of the wound inside the anus (which was very painful; the doctor told me to endure it).
The doctor mentioned that the wound should not heal too quickly to prevent debris from remaining.
However, when I returned home, I noticed that there was more bleeding on the gauze than usual.
Should I apply the medication with such force every time? If so, how long should I continue this? Will this method of treating the wound make it difficult to heal? Thank you, doctor, for listening to my concerns and responding.

Ahan, 30~39 year old female. Ask Date: 2021/06/08

Dr. Ke Fangxu reply Surgery

Indeed, after fistula surgery, if the wound heals too quickly, there is a higher risk of recurrence.
However, I personally did not apply pressure to the wound because it was too painful.
Additionally, a wound that does not heal properly is also a concern.
I recommend taking warm sitz baths at least four times a day and monitoring for any redness, swelling, heat, or pain.

Reply Date: 2021/06/08

More Info

Post-surgery care for anal fistula, particularly after a surgical procedure, is crucial for ensuring proper healing and minimizing complications. It is understandable to have concerns about the pain and the method of medication application as described in your situation. Here are some insights and recommendations based on your query.

Understanding the Procedure and Healing Process
After an anal fistula surgery, the healing process can be complex. The goal of the surgery is to remove the fistula and allow the surrounding tissue to heal properly. It is common for patients to experience some pain and discomfort during the healing phase, especially when applying medication or during follow-up examinations. The application of medication deep into the anal canal, as your doctor demonstrated, is often necessary to ensure that the medication reaches the affected area effectively.

Medication Application Tips
1. Gentle Application: While it is important to apply the medication correctly, it should not cause excessive pain. If the application is too painful, it may be worth discussing with your doctor. They might suggest a gentler technique or a different type of medication that could be less irritating.

2. Frequency of Application: The frequency of medication application will depend on your doctor's specific instructions. Typically, medications for anal fistulas are applied 1-3 times a day. Consistency is key, but if the application is causing significant pain or bleeding, it is essential to communicate this to your healthcare provider.

3. Monitoring for Complications: Increased bleeding after medication application can be a concern. If you notice that the bleeding is more than usual or if it persists, it is crucial to contact your doctor. They may need to assess the wound for any complications such as infection or improper healing.

4. Pain Management: Pain management is an important aspect of recovery. If the pain during medication application is severe, discuss with your doctor about using pain relief methods prior to the application. This could include over-the-counter pain relievers or prescribed medications.

5. Avoiding Excessive Pressure: While some pressure may be necessary to ensure the medication reaches the affected area, excessive force should be avoided. The goal is to apply the medication without causing additional trauma to the healing tissue.

Healing Expectations
Healing from anal fistula surgery can take time, and it is not uncommon for patients to experience fluctuations in pain and discomfort. The healing process can vary significantly from person to person. It is essential to follow your doctor's instructions closely and attend all follow-up appointments to monitor your progress.

When to Seek Further Help
If you experience any of the following, it is important to seek medical advice promptly:
- Increased pain that is not relieved by prescribed medications.

- Persistent or worsening bleeding.

- Signs of infection, such as fever, increased redness, or discharge from the wound.

- Any new symptoms that concern you.

Conclusion
In summary, while the application of medication for an anal fistula can be uncomfortable, it is crucial for healing. However, it should not be excessively painful. Communication with your healthcare provider is key to ensuring that you are comfortable with the treatment plan and to address any concerns about pain or bleeding. Always prioritize your comfort and well-being, and do not hesitate to reach out to your doctor for guidance tailored to your specific situation.

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