Post-Surgery Complications: Stitch Issues After Fistula Procedure

The stitches came loose on the second day post-surgery?

Dear Dr.
Chang,
I returned home to rest the day after my fistula surgery, but on the morning of the second day post-operation, I noticed some of the sutures had come loose (some have fallen off, while others are still attached to the wound).
The area feels slightly raised to the touch.
I have read that sutures typically fall out within 7-10 days.
Should I come in for an earlier appointment to address this issue? Thank you!
Note: 1.
The wound has only slight oozing of blood.
2.
I believe I had a simple fistula, and the surgery took less than 10 minutes.

Mr. You, 20~29 year old female. Ask Date: 2023/08/26

Dr. Zhang Shuhao reply Surgery

Fistula surgery will use absorbable sutures, which may come loose if there is significant tension on the wound; this is normal as long as there is no excessive bleeding.
No urgent intervention is required.
If the suture is hanging outside, avoid pulling on it.
You can carefully trim the ends or return to the clinic for the physician to remove it.

Reply Date: 2023/08/26

More Info

After undergoing a fistula procedure, it is not uncommon to experience some concerns regarding the surgical site, particularly with the stitches. In your case, the early detachment of some stitches and the protrusion of the wound can understandably cause anxiety. Here’s a comprehensive overview of what you might expect and what actions you should consider.

1. Understanding Stitch Issues: Stitches, or sutures, are used to hold the edges of the incision together during the healing process. In some cases, especially with simpler procedures, the stitches may dissolve on their own. However, if you notice that some stitches have fallen out prematurely, it could be due to several factors, including the type of sutures used, the tension on the wound, or even the healing process itself.
2. Wound Healing and Signs of Infection: The fact that you are experiencing only slight bleeding and that the wound feels slightly raised is not uncommon. However, it is crucial to monitor for signs of infection, which can include increased redness, swelling, warmth, or discharge that is yellow or green in color. If you notice any of these symptoms, it is essential to seek medical attention promptly.

3. When to Seek Medical Attention: Given that you are experiencing some stitch issues, it is advisable to consult your healthcare provider sooner rather than later. While it is typical for stitches to dissolve within 7-10 days, any unexpected changes in the wound should be evaluated. Your healthcare provider can assess whether the wound is healing properly and if any intervention is necessary.
4. Potential Complications: Although complications are rare, they can occur. If the wound is not properly closed, it may lead to delayed healing or even the formation of a new fistula. Additionally, if the wound becomes infected, it may require antibiotics or further surgical intervention.
5. Post-Operative Care: In the meantime, ensure that you are following post-operative care instructions. Keep the area clean and dry, avoid any unnecessary strain on the wound, and follow any specific guidelines provided by your surgeon regarding bathing or dressing changes.

6. Follow-Up Appointments: If your surgeon has scheduled follow-up appointments, make sure to attend them. These visits are crucial for monitoring your recovery and addressing any concerns that may arise. If you feel that your situation requires immediate attention before your next scheduled visit, do not hesitate to reach out to your healthcare provider.

In conclusion, while some degree of stitch detachment can occur, it is essential to remain vigilant about your wound's healing process. Given your symptoms, it would be prudent to contact your healthcare provider for an evaluation. They can provide you with the best course of action to ensure proper healing and address any complications that may arise. Your health and recovery are paramount, and timely medical advice can make a significant difference in your post-operative experience.

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