Post-Surgery Care for Anal Fistula: Managing Pain and Healing Concerns

Postoperative care for anal fistula surgery?

Hello, doctor.
I previously underwent anal fistula surgery on March 18, with the wound located in the perineal area, approximately 8 cm in length and about one finger's depth.
After two months, the wound has healed, and I just started back to work this week.
Due to the nature of my job, I need to sit for long periods, and I have started to feel some discomfort over the past two days.
I would like to ask: 1.
The healed wound near the anus in the perineal area causes slight pain when pressed (it did not hurt before I returned to work).
What could be the reason for this? 2.
Currently, I am applying Neomycin ointment to the wound once in the morning and once at night.
Is there anything else I need to pay attention to? 3.
What signs or symptoms should prompt me to return for a follow-up visit?

Niming, 30~39 year old female. Ask Date: 2022/05/25

Dr. Ke Fangxu reply Surgery

1.
Larger wound management may result in a longer healing time, and mild pain caused by pressure or prolonged sitting is considered normal.

2.
If the wound has completely healed, no special treatment is necessary, and applying ointment is not required.

3.
If there is redness, swelling, heat, pain, or purulent discharge, it indicates a wound infection or a recurrence of a fistula, and a follow-up appointment for evaluation and treatment is necessary.

Reply Date: 2022/05/25

More Info

Post-surgery care for an anal fistula can be quite challenging, especially when it comes to managing pain and ensuring proper healing. It’s great to hear that your wound has healed after two months, but it’s not uncommon to experience discomfort, especially when returning to a job that requires prolonged sitting. Let’s address your concerns one by one.

1. Pain Near the Healing Wound: The mild pain you’re experiencing near the anal area could be attributed to several factors. First, the healing process can sometimes cause sensitivity in the surrounding tissues, especially if you are sitting for long periods. Pressure on the area can lead to discomfort as the tissues are still adjusting post-surgery. Additionally, if you are engaging in activities that strain the pelvic area or if you are experiencing any form of constipation, this could exacerbate the pain. It’s essential to ensure that you are not straining during bowel movements, as this can lead to increased pressure and discomfort in the area.
2. Wound Care: Applying Neomycin ointment twice daily is a good practice for preventing infection. However, there are additional steps you can take to promote healing and comfort. Ensure that you are keeping the area clean and dry. After bowel movements, gentle cleansing with warm water (avoiding harsh soaps) can help maintain hygiene without irritating the area. You might also consider using a sitz bath, which involves sitting in warm water for about 15-20 minutes a few times a day. This can help soothe the area and promote blood flow, aiding in healing. Additionally, maintaining a high-fiber diet and staying hydrated can prevent constipation, which is crucial for avoiding strain on the surgical site.

3. Signs to Seek Immediate Medical Attention: It’s important to monitor your wound for any signs of complications. You should seek immediate medical attention if you notice any of the following: increased redness or swelling around the wound, discharge that is foul-smelling or contains pus, a significant increase in pain, fever, or any signs of systemic infection. If you experience any changes in bowel habits, such as severe constipation or diarrhea, or if you notice any unusual lumps or bumps near the surgical site, these are also reasons to consult your healthcare provider.

In summary, while some discomfort is normal as you return to your routine, it’s essential to listen to your body. If the pain persists or worsens, or if you have any concerns about your healing process, don’t hesitate to reach out to your healthcare provider. They can provide tailored advice and, if necessary, conduct a physical examination to ensure that everything is healing as it should. Remember, your comfort and health are paramount, and proactive care can help prevent complications down the line.

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