Post-Surgery Recovery Tips for Fistula Surgery: Healing Insights and Advice

Post-fistula surgery

Hello Doctor, I had a fistula excision surgery on November 15th.
The surgical site is located just above the anal opening, around the 11 o'clock position.
I took three weeks off and mostly rested at home, lying down except for meals and sitz baths.
During my follow-up appointment on December 3rd, the doctor said my wound had healed about 90% and that I didn't need to return for further check-ups.
I started working again on December 6th.
Initially, while sitting for long periods, I experienced some pain in the perineum and the wound area, but it seemed to improve after sitting for 3 to 4 days.
1.
Could this pain be due to the fact that I had been lying down for an extended period? Since the surgery, I have mostly been eating porridge and vegetables, and I have been having bowel movements three times a day.

2.
Is this frequency of bowel movements detrimental to wound healing?
3.
How can I determine if the wound has fully healed? In a few days, it will be one month since the surgery.
I am still maintaining sitz baths four times a day, but I occasionally experience sudden pain while walking, and there is still a small amount of discharge on my sanitary pad.

4.
Is this situation normal? Is it possible that the wound from the excision surgery heals more slowly than that from an incision surgery?
5.
If the external wound has healed but the internal wound has not, does this necessarily mean that the internal tissue will not regenerate and that I will need another surgery?
6.
Are there any methods to promote faster healing of the internal tissue?
7.
Should I avoid lying down for long periods and instead walk and sit more to help the muscles expel the discharge?

123, 30~39 year old female. Ask Date: 2021/12/11

Dr. Ke Fangxu reply Surgery

1.
After returning to work, it's common to experience some pain from prolonged sitting; as long as there is no severe pain, it should not be a concern.

2.
No.

3.
Wound healing typically takes about one month; if there is no discharge and no pain, it indicates that healing has occurred.

4.
Normal.

5.
It depends on whether an infection has occurred.

6.
Maintain good bowel habits and take warm sitz baths regularly.

7.
Continue with normal daily routines; there is no need for excessive walking or sitting.

Reply Date: 2021/12/11

More Info

Post-surgery recovery, especially after a fistula surgery, can be a complex process that requires careful attention to both physical and emotional well-being. Based on your description, it seems you are experiencing a mix of discomfort and uncertainty about your healing process. Here are some insights and advice to help guide you through your recovery:
1. Understanding Pain and Discomfort: It's common to experience pain or discomfort in the perineal area after surgery, especially if you have been lying down for extended periods. The transition from lying down to sitting or standing can cause temporary discomfort as your body adjusts. The fact that your pain has decreased after a few days of sitting at work suggests that your body is beginning to adapt to normal activities. However, if the pain persists or worsens, it's essential to consult your healthcare provider.

2. Diet and Bowel Movements: Your current diet of porridge and vegetables is generally good for recovery, as it is likely low in irritants and high in fiber, which can help with bowel movements. Having three bowel movements a day can be normal, but if you notice any changes in consistency or if you experience discomfort during bowel movements, it may be worth discussing with your doctor. Adequate hydration is also crucial for healing, so ensure you're drinking enough fluids.

3. Wound Healing: To assess whether your wound is healing properly, look for signs such as reduced redness, swelling, and drainage. A small amount of discharge can be normal, especially in the early stages of healing. If the discharge becomes foul-smelling or if you notice increased redness or swelling, these could be signs of infection, and you should seek medical advice. Regular sitz baths can help keep the area clean and promote healing.

4. Healing Timeline: It's important to understand that healing from fistula surgery can vary significantly from person to person. Generally, external wounds may heal faster than internal ones. Just because the outer wound appears to be healing does not necessarily mean that the internal tissues are fully healed. If you have concerns about the internal healing process, discussing these with your surgeon can provide clarity.

5. Activity Level: While resting is essential for recovery, prolonged inactivity can lead to complications such as muscle atrophy or increased risk of blood clots. Gradually increasing your activity level, such as walking and sitting for short periods, can promote circulation and help with the healing process. Listen to your body; if you feel pain, it’s important to rest and not push yourself too hard.

6. Promoting Internal Healing: There are no guaranteed methods to expedite internal healing, but maintaining a healthy diet, staying hydrated, and following your doctor's post-operative care instructions can support the healing process. If you have specific concerns about the internal healing of your wound, your surgeon may recommend follow-up imaging or examinations to assess the healing progress.

7. Follow-Up Care: Regular follow-ups with your healthcare provider are crucial. If you notice any changes in your symptoms or if you have concerns about your recovery, do not hesitate to reach out to your doctor. They can provide personalized advice based on your specific situation.

In summary, your recovery process is unique, and while some discomfort is expected, it’s essential to monitor your symptoms closely. Gradually increasing your activity level, maintaining a healthy diet, and keeping in touch with your healthcare provider will help ensure a smoother recovery. Remember, healing takes time, and being patient with yourself is key.

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