Persistent Wound in Groin After Surgery: Concerns and Next Steps

Wound in the groin that is not healing?

Hello Doctor, I underwent a fistula surgery on January 3rd this year, and there is a small wound in the gluteal cleft, between the coccyx and the anal area, that has not healed.
According to the surgeon, the wound is very small, similar to a superficial abrasion, and as long as there is no redness, swelling, heat, or pain, it does not require special attention.
Currently, the wound tends to crack and ooze blood approximately every 2 to 3 weeks.
Although the amount of blood is minimal and stops quickly, its location, where stool passes, makes me quite anxious.
I do not have diabetes, and my blood sugar levels have been normal during regular check-ups.
Could this wound lead to further infection, such as erosion of the coccyx? If I wish to seek further treatment, should I continue to see a colorectal surgeon, or should I consult another specialty?

joey, 30~39 year old female. Ask Date: 2023/07/10

Dr. Ke Fangxu reply Surgery

If the wound is located at the surgical site and has not healed after six months, it is important to consider the possibility of recurrence.
However, erosion of the coccyx is unlikely to occur.
It is advisable to have a colorectal surgeon reassess the situation.

Reply Date: 2023/07/10

More Info

After undergoing surgery for a fistula on January 3rd, you are experiencing a persistent wound in the groin area that has not healed properly. It is understandable to feel anxious about this situation, especially given its location and the potential for complications.
First, it is important to recognize that wounds in areas that are frequently subjected to movement and pressure, such as the groin, can sometimes take longer to heal. The fact that your surgeon has indicated that the wound is small and not exhibiting signs of infection (such as redness, swelling, or warmth) is a positive sign. However, the intermittent bleeding and the fact that it opens up every few weeks are concerning and warrant further attention.

Regarding your concerns about potential complications, such as infection or erosion of the tailbone, it is essential to monitor the wound closely. While the risk of serious complications like osteomyelitis (infection of the bone) is generally low, especially in the absence of systemic symptoms, it is not entirely out of the question. The location of the wound, near the anus, does expose it to bacteria that could potentially lead to infection if not managed properly.

If you are considering further treatment, it would be advisable to continue consulting with a colorectal surgeon, as they specialize in conditions related to the rectum and anus. They can provide a thorough evaluation of the wound and determine if any additional interventions are necessary, such as debridement (removal of dead or infected tissue), or if a different treatment plan is warranted. If the colorectal surgeon feels that the wound is healing appropriately and does not require further intervention, they may also refer you to a wound care specialist who can provide targeted treatment to promote healing.

In the meantime, here are some general recommendations to help manage your wound:
1. Keep the Area Clean: Gently clean the wound with mild soap and water. Avoid using harsh chemicals or scrubbing the area too vigorously.

2. Moisture Management: Keeping the wound moist can promote healing. Consider using a hydrogel or a specialized wound dressing that maintains a moist environment.

3. Avoid Irritation: Since the wound is in a location that is subject to friction and pressure, try to minimize activities that could irritate the area. Wearing loose-fitting clothing may help.

4. Monitor for Signs of Infection: Continue to watch for any changes in the wound, such as increased redness, swelling, warmth, or discharge. If you notice any of these signs, seek medical attention promptly.

5. Follow-Up Appointments: Ensure that you attend all follow-up appointments with your surgeon or healthcare provider to monitor the wound's progress.

In summary, while the small size of the wound and the absence of significant symptoms are encouraging, your ongoing concerns are valid. It is crucial to maintain open communication with your healthcare providers and seek further evaluation if the wound does not improve or if you have any new symptoms. Your health and peace of mind are paramount, and addressing these concerns with a specialist will help ensure the best possible outcome.

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