Delayed Healing After Appendectomy: Concerns and Recovery Insights

The incision from appendicitis surgery has not healed one month post-operation?

Hello doctor, I would like to ask a question for my mother.
It has been nearly a month since she had her appendectomy.
Two weeks after the surgery, she went to another clinic to have her stitches removed.
During the process, the doctor informed her that the surgeon who performed the operation forgot to stitch the internal layers, so she was referred back to the original surgeon for re-stitching, which involved two additional stitches.
Two weeks later, when my mother went to have the stitches removed again, the doctor said her wound was still a bit moist because some yellow fluid was still draining, making it unsuitable for stitch removal.
However, my mother insisted on having them removed since it had been almost a month.
After the removal, she now has a small hole near her navel.
Can this wound heal properly over time? Additionally, she has been experiencing a sensation of needing to have a bowel movement whenever she urinates.
Is this situation normal? How long will it take for her to return to normal? She also has a chronic condition, diabetes.

Yifang, 60~69 year old female. Ask Date: 2021/08/26

Dr. Chen Jiaming reply Surgery

The wound healing status varies based on the original condition (appendicitis -> appendicitis is classified as an intra-abdominal infection), age, nutritional status, diabetes, and wound care methods, among other factors.
Although it has been a month, since the doctor indicated that it was not appropriate to remove the stitches, and your mother insisted on having them removed, the only option is to gradually change the dressings and maintain wound cleanliness to prevent infection.
There is still a chance for gradual healing (the size of the hole you mentioned is unclear).
As for the urge to defecate when urinating, this is caused by adhesions resulting from the intra-abdominal infection.
Generally, this will improve gradually, but there is no specific timeframe to reference.

Reply Date: 2021/08/26

More Info

After an appendectomy, it is not uncommon for patients to experience delayed healing, especially in the presence of underlying health conditions such as diabetes. Your mother's situation raises several important points that need to be addressed.

Firstly, the fact that your mother had to undergo a secondary procedure to close the internal sutures indicates that there may have been complications during the initial surgery. Incomplete suturing can lead to increased risk of infection and delayed healing. The presence of yellow fluid, which could be a sign of serous fluid or even infection, suggests that the wound is not healing as expected. It is crucial to monitor the wound closely for any signs of infection, such as increased redness, swelling, warmth, or discharge that changes in color or odor.

Regarding the wound healing process, it is essential to understand that healing can be affected by various factors, including the patient's overall health, nutrition, and the presence of chronic conditions like diabetes. Diabetes can impair circulation and the body’s ability to heal, making it vital for your mother to manage her blood sugar levels effectively. Elevated blood sugar can lead to poor wound healing and increase the risk of infections.

As for the concern about the belly button area still having an opening, it is important to keep the area clean and dry. Small openings can sometimes heal on their own, but if the wound does not show signs of improvement or if there is any concern about infection, it is advisable to consult with a healthcare professional. They may recommend a follow-up appointment to assess the wound and possibly provide additional treatment, such as antibiotics if an infection is suspected.

The sensation of needing to urinate while feeling the urge to have a bowel movement can be attributed to several factors. After abdominal surgery, the body can experience changes in how the organs function and communicate with each other. The surgical manipulation of the intestines and surrounding structures can lead to temporary changes in bowel and bladder habits. However, if this sensation persists, it is important to discuss it with a healthcare provider to rule out any complications, such as adhesions or other gastrointestinal issues.

In terms of recovery time, it varies significantly from person to person. Generally, most patients can expect to return to normal activities within a few weeks, but complete healing of the internal structures may take longer. It is essential for your mother to follow her doctor's post-operative care instructions, including any dietary recommendations, activity restrictions, and follow-up appointments.

In summary, your mother's recovery from appendectomy may be complicated by her diabetes and the issues encountered during her surgery. It is crucial to maintain open communication with her healthcare providers, monitor her wound closely, and address any new or concerning symptoms promptly. If there are ongoing issues with her bowel and bladder function, or if the wound does not appear to be healing, further evaluation may be necessary to ensure her recovery proceeds smoothly.

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