Post-Surgery Concerns: Hard Lumps and Healing After Fistula Surgery

Post-fistula surgery

Hello Doctor, I underwent surgery for an anal fistula on March 18 of this year.
The wound extends approximately 8 centimeters from the anus to the perineum and is about one finger's depth.
It healed around the end of May, but later, sitting for too long at work caused the scar to become red, swollen, and warm.
The doctor prescribed Concoly for me to apply, which helped reduce the redness and swelling.
However, as of August, there is still a long hard lump within the scar that occasionally feels warm and uncomfortable when pressed, and it appears dark red on the surface.
The doctor examined it and said there should be no issues, advising me to observe it for a while longer.
I would like to ask: 1.
What could this hard lump be, and how much longer might it take to resolve on its own? 2.
Is it normal for the area with the hard lump to feel warm frequently? 3.
I am still applying Concoly; should I be concerned that if I stop, it might become red and swollen again?

Niming, 30~39 year old female. Ask Date: 2022/08/07

Dr. Ke Fangxu reply Surgery

1.
If it is not a recurrence of the fistula, then it is likely just scar tissue that will gradually soften after about six months post-healing.

2.
Fever may be caused by irritation of the scar tissue due to friction; as long as there is no redness, swelling, or pus, it should not be a concern.

3.
Concoly is a multi-component topical ointment for the skin; it can be applied with a cloth.
I suggest you stop applying it for now and monitor any subsequent changes.

Reply Date: 2022/08/07

More Info

After undergoing fistula surgery, it is not uncommon to experience various post-operative symptoms, including the formation of hard lumps, redness, and discomfort at the surgical site. Your concerns about the hard lump and the healing process are valid, and I will address your questions based on medical knowledge and common post-surgical experiences.

1. What could the hard lump be, and how long might it take to resolve?
The hard lump you are feeling could be a few different things. One possibility is that it is a scar tissue formation, also known as fibrosis, which can occur as part of the normal healing process. Scar tissue can feel firm and may take time to soften and become less noticeable. Another possibility is that it could be a localized area of inflammation or even a small seroma (a collection of fluid) that has become encapsulated. In some cases, a lump can also indicate an infection or an abscess, especially if it is associated with warmth and discomfort. Generally, scar tissue can take several months to a year to mature and soften. However, if the lump persists, continues to grow, or is accompanied by increasing pain or other symptoms, it is crucial to follow up with your healthcare provider for further evaluation.

2. Is it normal for the lump to feel warm?
The sensation of warmth in the area of the lump can be a sign of inflammation. While some warmth can be a normal part of the healing process, especially if there has been recent activity or pressure on the area (such as sitting for extended periods), persistent warmth may indicate an underlying issue, such as infection. It is essential to monitor this symptom closely. If the warmth is accompanied by increased redness, swelling, or discharge, or if you develop fever or chills, you should seek medical attention promptly.

3. Should I continue using the topical medication (康可麗)?
Continuing to apply the topical medication as prescribed by your doctor is advisable, especially if it has helped reduce redness and swelling. Topical treatments can aid in managing inflammation and promoting healing. However, if you are concerned about the lump or if you notice any changes in the area, it is best to consult your physician. They may recommend adjusting your treatment plan or suggest alternative therapies to help with the healing process.

In summary, while some post-operative symptoms are common, it is essential to remain vigilant about any changes in your condition. Regular follow-ups with your healthcare provider are crucial to ensure proper healing and to address any complications that may arise. If you have any concerns about the lump, warmth, or overall healing process, do not hesitate to reach out to your doctor for further evaluation and guidance. Your health and comfort are paramount, and proactive communication with your healthcare team will help ensure the best outcomes.

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