Post-Surgery Care for Hemorrhoid Granulation Tissue Removal: What to Expect

Granulation tissue excision after hemorrhoid surgery?

Hello, Doctor.
During my follow-up appointment on January 9th, I underwent excision of granulation tissue after hemorrhoid surgery (there was bleeding at the time, and gauze was applied for hemostasis).
It has been about 25 days since the hemorrhoid surgery, and the granulation tissue is about the size of a small green bean, located right at the anal opening.
On January 10th, I suddenly noticed bleeding from the anus, but I'm not sure if it was from the excised granulation tissue.
I would like to ask how long it typically takes for the wound from granulation tissue excision to heal? On the night of January 1st, I went to the emergency room due to sudden and persistent anal bleeding, which was about 17 days post-surgery.
A colonoscopy revealed bleeding at the suture site, and the attending physician used a hemostatic clip to control the bleeding.
I'm concerned that this recent bleeding might be from the same area.
The attending physician prescribed a topical ointment called "Le Yu Zhi" and advised me to apply it deeply to the wound site after excising the granulation tissue, but I have a personal aversion to applying it deeply.
Therefore, I would like to ask if it's sufficient to apply the ointment just around the anal opening? Thank you!

Mr. Chen, 30~39 year old female. Ask Date: 2024/01/10

Dr. Zhang Shuhao reply Surgery

Twenty-five days after hemorrhoid surgery, the wound has mostly healed and does not appear to be bleeding like a surgical wound.
Granulation tissue removal may occasionally cause some bleeding, but since there are no major blood vessels internally, appropriate pressure for a day can usually stop the bleeding.
If the excision area is larger, additional cauterization or silver nitrate may be performed to control bleeding.
If it is difficult to apply medication deeply, it can be applied only at the anal opening.
As long as the amount of bleeding gradually decreases, there is no need for concern.

Reply Date: 2024/01/10

More Info

Post-surgery care for hemorrhoid granulation tissue removal is crucial for ensuring proper healing and minimizing complications. After the removal of granulation tissue, which can occur at the anal region, patients may experience some bleeding, discomfort, and the need for careful management of the surgical site.

What to Expect After Surgery
1. Bleeding: It is not uncommon to experience some bleeding after the removal of granulation tissue. This can occur due to the surgical site being sensitive and still healing. If you notice bright red blood, it may indicate that the area is still healing or that there may be a need for further evaluation if the bleeding is excessive.

2. Healing Time: The healing process for the surgical site can vary from person to person. Generally, granulation tissue removal sites can take anywhere from 2 to 4 weeks to heal completely, depending on individual health factors, the extent of the surgery, and adherence to post-operative care instructions.

3. Pain and Discomfort: It is normal to experience some pain or discomfort in the area post-surgery. Over-the-counter pain relief medications can help manage this discomfort. However, if the pain is severe or worsening, it is essential to contact your healthcare provider.

4. Signs of Infection: Watch for signs of infection, such as increased redness, swelling, warmth in the area, or discharge that is foul-smelling. If you experience any of these symptoms, seek medical attention promptly.

Post-Operative Care Instructions
1. Wound Care: It is essential to keep the surgical site clean and dry. You may be advised to take sitz baths to soothe the area and promote healing. Avoid using harsh soaps or irritants around the area.

2. Medication Application: If your doctor has prescribed a topical medication (like the "樂癒痔" ointment), it is important to follow their instructions. If you feel uncomfortable applying it deeply, you can apply it gently around the anal area, but ensure that you are covering the surgical site adequately. If you have concerns about applying the medication, discuss this with your healthcare provider for alternatives or modifications.

3. Diet and Hydration: Maintaining a high-fiber diet and staying well-hydrated can help prevent constipation, which can strain the surgical site during bowel movements. Consider incorporating fruits, vegetables, and whole grains into your meals.

4. Activity Level: Avoid heavy lifting or strenuous activities that could put pressure on the surgical site. Gentle walking is encouraged to promote circulation and healing.

5. Follow-Up Appointments: Keep all follow-up appointments with your healthcare provider to monitor the healing process and address any concerns. If you experience recurrent bleeding or any other complications, do not hesitate to reach out to your doctor.

Conclusion
In summary, after the removal of granulation tissue from hemorrhoids, it is essential to monitor for bleeding, follow proper wound care, and maintain a healthy diet to facilitate healing. If you have any concerns about your recovery or experience unusual symptoms, contact your healthcare provider for guidance. Your health and comfort are paramount, and your doctor can provide tailored advice based on your specific situation.

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