Granulation Tissue After Fistula Surgery: What to Expect

A granulation tissue has developed next to the wound after the fistula surgery?

Hello Dr.
Ke, I previously asked about a complex fistula.
After the surgery in mid-July, the skin around the wound has become firm.
Recently, in the past two weeks, a growth resembling granulation tissue has appeared next to the wound.
It does not hurt when pressed, and I am unsure if this is normal or abnormal.
My attending physician has not been available for consultation in the past few days, so I am a bit worried.
Here is the link to the wound image: https://ibb.co/Cmk2F1T.
Thank you for your assistance.

Sam, 30~39 year old female. Ask Date: 2021/09/09

Dr. Ke Fangxu reply Surgery

Based on the images, it appears to be a recurrence of the fistula.
I recommend that you consult your surgeon for an evaluation, as it may be necessary to undergo another surgery.

Reply Date: 2021/09/09

More Info

After undergoing surgery for a complex fistula, it is not uncommon to observe changes in the surrounding tissue, including the formation of granulation tissue. Granulation tissue is a normal part of the healing process and typically appears as a fleshy, red, or pink tissue that can feel firm or hard to the touch. This tissue is composed of new connective tissue and blood vessels that form during the healing of a wound.
In your case, the hard area around the surgical site and the appearance of a "meat-like" growth could indeed be granulation tissue. It is a sign that your body is actively healing the area. Granulation tissue is usually not painful when pressed, which aligns with your observation that the area does not hurt when you apply pressure. However, it is essential to monitor the growth for any changes in size, color, or pain, as these could indicate complications.

While granulation tissue is generally a normal part of the healing process, there are a few things to consider. If the tissue becomes excessively large or if you experience increased pain, discharge, or any signs of infection (such as redness, warmth, or swelling), it would be prudent to consult your healthcare provider. In some cases, excessive granulation tissue, also known as "proud flesh," may require treatment to reduce its size, especially if it interferes with healing or causes discomfort.

It is also important to maintain proper wound care as advised by your surgeon. Keeping the area clean and dry can help prevent infection and promote healthy healing. If your surgeon has provided specific instructions regarding wound care, be sure to follow them closely.

In summary, the presence of granulation tissue after fistula surgery is typically a normal part of the healing process. However, it is essential to remain vigilant and consult your healthcare provider if you notice any concerning changes. If your surgeon is unavailable, consider reaching out to another healthcare professional for a second opinion or reassurance regarding your healing process. Your health and peace of mind are paramount, and it is always better to err on the side of caution when it comes to post-surgical recovery.

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