Post-Surgery Concerns: Managing Anal Fistula and Polyp in Infants - Surgery

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Postoperative care for anal fistula surgery?


Doctor, I would like to ask a couple of questions:
1.
My baby had an anal fistula surgery at 4 months old, and during the healing process, a large polyp developed.
When we took him to the doctor, the doctor removed it with a cotton swab, but it grew back in less than a week.
Why does this keep happening?
2.
Now that my baby is almost 6 months old, the wound has suddenly broken open and is bleeding a little.
Is this normal?

A Chou, 20~29 year old female. Ask Date: 2022/01/27

Dr. Zhang Shuhao reply Surgery


The polyp described in the text may be granulation tissue that has formed at the site of a wound.
If it grows excessively, it can lead to an uneven appearance, so it is fine to remove it in an outpatient setting.
Newly healed wounds tend to be more fragile and can easily bleed from friction, so it is advisable to take warm water sitz baths and apply ointment regularly.
Follow-up visits for monitoring are also recommended.
Children typically recover quickly, so there is no need for excessive worry.
Wishing your baby a speedy recovery.

Reply Date: 2022/01/27

More Info


When it comes to managing post-surgery concerns in infants, particularly regarding anal fistulas and polyps, there are several important factors to consider. Your concerns about your baby's condition are valid, and it's essential to understand the underlying reasons for the recurring issues and how to manage them effectively.

1. Recurring Polyps: The recurrence of polyps after surgical removal can be frustrating and concerning. Polyps in infants, especially after surgery for an anal fistula, may arise due to several reasons. First, the healing process can sometimes stimulate the growth of new tissue, which may manifest as a polyp. Additionally, if the initial polyp was not completely excised, it could regrow. In some cases, the tissue around the surgical site may be reactive, leading to the formation of new polyps. It's crucial to follow up with your pediatric surgeon or a pediatric gastroenterologist to monitor the situation closely. They may recommend further evaluation or a different approach to treatment if the polyps continue to recur.

2. Wound Healing and Bleeding: Regarding the wound that has suddenly broken open and is bleeding, this is not uncommon in the healing process, especially in infants. The skin around surgical sites can be delicate and may break down if there is friction, irritation, or if the area is not kept clean and dry. However, any bleeding should be taken seriously. If the bleeding is minimal and stops quickly, it may not be a cause for alarm, but you should still consult your healthcare provider to ensure that there are no underlying issues. If the bleeding persists, is significant, or if there are signs of infection (such as increased redness, swelling, or discharge), you should seek medical attention promptly.


Additional Considerations:
- Follow-Up Care: Regular follow-up appointments with your child's healthcare provider are essential to monitor the healing process and address any complications that may arise. They can provide guidance on wound care and signs to watch for that may indicate a problem.

- Wound Care: Keeping the surgical site clean and dry is crucial. Your healthcare provider may recommend specific cleaning solutions or ointments to promote healing and prevent infection. Avoiding tight clothing and ensuring that the area is not irritated by diapers or other materials can also help.

- Dietary Considerations: If your baby is starting to eat solid foods, ensure they are getting a balanced diet that includes fiber to promote healthy bowel movements. This can help reduce strain during bowel movements, which is particularly important for healing after anal surgery.

- Monitoring for Symptoms: Keep an eye on your baby for any signs of discomfort, changes in bowel habits, or unusual symptoms. If your baby seems to be in pain or is having difficulty with bowel movements, it’s important to discuss these issues with your healthcare provider.

In summary, while the recurrence of polyps and issues with wound healing can be concerning, they are not uncommon in infants following surgery for anal fistulas. Close monitoring, proper wound care, and regular follow-ups with your healthcare provider are key to managing these concerns effectively. If you have any further questions or if your baby's condition changes, do not hesitate to reach out to your healthcare provider for guidance and support.

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