Delayed Healing After Anal Fistula Surgery: What to Do Next?

The anal fistula surgery was performed nearly two months ago, and the wound has still not healed?

Hello Doctor, I underwent an anal fistula excision surgery at a large hospital on September 6th of this year.
During my follow-up appointment, the doctor indicated that the wound was healing well, and after my visit on October 7th, I was told that no further follow-ups were necessary.
However, three weeks have passed, and the wound still appears as shown in the image (the red line indicates the original size of the surgical wound).
I have a long-standing issue with soft stools or diarrhea in the mornings (usually, I only have a bowel movement once in the morning).
Could the shape of my stools be causing an infection in the wound? Should I first consult a gastroenterologist to normalize my bowel movements before returning to the colorectal specialist for a wound check, or should I go directly back to the colorectal specialist? Or should I wait a bit longer? Thank you, Doctor.

Mr. Wang, 20~29 year old female. Ask Date: 2021/10/29

Dr. Ke Fangxu reply Surgery

The wound appears to show no signs of infection; however, it is indeed unusual that it has not healed after such a long time post-surgery.
Soft stools can potentially delay wound healing.
Nevertheless, I recommend that you consult your surgeon for a follow-up examination.
If necessary, a debridement procedure may be considered.

Reply Date: 2021/10/29

More Info

After undergoing anal fistula surgery, it is not uncommon to experience delayed healing, which can be concerning for patients. In your case, it has been several weeks since your surgery, and the wound has not shown significant improvement. The wound's size and appearance remaining relatively unchanged can indicate a few potential issues that may need to be addressed.

First, it is essential to understand that the healing process can vary significantly from person to person. Factors such as age, overall health, nutritional status, and the presence of underlying conditions (like diabetes) can all impact wound healing. Additionally, the nature of the surgery itself and the complexity of the fistula can also play a role in how quickly and effectively the wound heals.

Given your history of soft stools or diarrhea, it is possible that the consistency of your bowel movements could be affecting the healing of your surgical site. Frequent bowel movements, especially if they are loose, can lead to irritation and may contribute to the risk of infection or delayed healing. The pressure and friction from bowel movements can disrupt the healing tissue, making it more challenging for the wound to close properly.

In terms of next steps, it would be advisable to consult with your colorectal surgeon again. They can assess the wound's current state and determine if there are any signs of infection or other complications that may require intervention. If the surgeon believes that the wound is healing appropriately but just slowly, they may provide you with specific care instructions to promote healing, such as keeping the area clean and dry, using topical treatments, or adjusting your diet to help regulate your bowel movements.

Additionally, it may be beneficial to see a gastroenterologist to address your bowel habits. If your soft stools or diarrhea can be managed effectively, this may help reduce irritation around the surgical site and promote better healing. The gastroenterologist can evaluate your diet, lifestyle, and any underlying gastrointestinal issues that may be contributing to your symptoms.

In summary, while it is essential to monitor the healing of your surgical site, addressing your bowel habits may also play a crucial role in the healing process. It is advisable to follow up with both your colorectal surgeon and a gastroenterologist to ensure a comprehensive approach to your recovery. Keeping an open line of communication with your healthcare providers will help you navigate this healing process more effectively and ensure that you receive the appropriate care tailored to your specific needs.

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